C26MC-0007_VEBA_Consulting_Services_RFP.pdf

Gavin Newsom, Governor

State of California Health and Human Services Agency

DEPARTMENT OF MANAGED HEALTH CARE

980 9th Street, Suite 500

Sacramento, CA 95814 Phone: 916-324-8176 | Fax: 916-255-5241 www.DMHC.ca.gov

June 11, 2026

REQUEST FOR PROPOSAL – Primary Voluntary Employees’ Beneficiary Association or Trust Fund Consulting Services

RFP No. C26MC-0007

You are invited to review and respond to the Department of Managed Health Care’s (DMHC) Request for Proposal (RFP) entitled “Voluntary Employees’ Beneficiary Association or Trust Fund (VEBA) Consulting Services”. Potential Proposers may download the solicitation package and any future addendums from Cal eProcure. In submitting a proposal, you must comply with the instructions found herein. The deadline for submitting proposals is July 9, 2026, 4 p.m. Pacific Daylight Time (PDT).

The DMHC is soliciting proposals from qualified entities to provide consulting services by performing, participating in and reviewing the analyses, activities and communications of the qualifying VEBA and its contracted health care providers. A successful Proposer will be awarded a two-year contract anticipated to begin on October 1, 2026 or Upon Approval, whichever is earlier, and end on September 30, 2028. The DMHC reserves the right to extend the contract for an additional one-year term at the same rates and maximum dollar amount per year as the original Agreement. Contract extensions are subject to satisfactory performance, funding availability and approval by the Department of General Services (DGS).

The Small Business (SB) Preference and other preference programs apply to this solicitation. The Disabled Veteran Business Enterprise (DVBE) participation requirement has been waived; however, the DVBE Incentive Program will apply for this solicitation.

All agreements entered into with the State of California will include by reference General Terms and Conditions and Contractor Certification Clauses. A hard copy can be provided by contacting the person listed below.

In the opinion of the DMHC, this RFP is complete. However, if you have questions or need clarifying information, please contact:

Lesya Vorobets DMHC Contract Analyst

Contracts.Unit@dmhc.ca.gov

Please note that no verbal information given will be binding upon the State unless such information is issued in writing as an official addendum to this solicitation.

https://caleprocure.ca.gov/ https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-Updates/GTC-225-February-2025.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-Updates/GTC-225-February-2025.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf mailto:Contracts.Unit@dmhc.ca.gov

TABLE OF CONTENTS

A. PURPOSE AND DESCRIPTION OF SERVICES

B. BACKGROUND

C. SCOPE OF WORK

D. ADMINISTRATIVE REQUIREMENTS

E. PROPOSAL REQUIREMENTS AND INFORMATION

1. Anticipated Key Action Dates

2. Submission of Questions

3. General Requirements

4. References

5. Resumes

6. Work Plan

7. Proposal Format and Requirements

8. Electronic Submission Instructions

9. Disposition of Proposals

10. Evaluation Process and Criteria

11. Award and Protest

12. Agreement Execution and Performance

F. PREFERENCE PROGRAMS

G. DISABLED VETERAN BUSINESS ENTERPRISE INCENTIVE PROGRAM

H. NEWS RELEASES AND SOCIAL MEDIA

I. EXECUTIVE ORDER N-6-22 – RUSSIA SANCTIONS

J. EXECUTIVE ORDER N-12-23 – GENERATIVE ARTIFICIAL INTELLIGENCE

K. ATTACHMENTS

L. SAMPLE AGREEMENT

Department of Managed Health Care Voluntary Employees’ Beneficiary Association or Trust Fund Consulting Services

RFP No. C26MC-0007

A. PURPOSE AND DESCRIPTION OF SERVICES

The Contractor shall perform, participate in and review the analyses, activities and communications of the qualifying VEBA and its contracted health care providers. Also, the Contractor shall assist with preparing a written report to the Legislature summarizing the information compiled during the pilot program, as described in the California Health and Safety Code (HSC) section 1343.3 (a)(11)(B) and (g).

The Contractor shall review the annual information provided by the VEBA concerning comparative cost savings when comparing capitation to fee-for-service payments;

performance measures for clinical patient outcomes; and enrollee satisfaction meeting the criteria outlined in HSC section 1343.3(a)(11)(A). This analysis must be performed under the data standards currently used by the Integrated Healthcare Association’s Align.Measure.Perform. (AMP) program and the California Regional Health Care Cost and Quality Atlas.

The DMHC intends to award one Agreement, to one Proposer, but does not guarantee any specific volume of work upon award. The cost of any Agreement resulting from this RFP shall not exceed $243,000.00.

The DMHC reserves the right to extend the Agreement up to an additional one year at the same rates and maximum dollar amount per year as the original Agreement and/or amend to increase funding for additional VEBA consulting services. Agreement amendments are subject to satisfactory performance, funding availability and may require approval from the DGS. Agreement amendments will not take effect until the Contractor has received a copy of the final contract document signed by the DMHC Contract Officer or designee and approved by the DGS if applicable.

B. BACKGROUND

California Assembly Bill (AB) 1124 (Maienschein, 2020) effective January 1, 2021, adds and repeals HSC section 1343.3.1.1 AB 1124 authorizes the DMHC to approve two pilot programs whereby providers approved by the DMHC may undertake risk-bearing arrangements with a qualifying VEBA.2

AB 2063 effective September 28, 2024, extended the pilot program end date from December 31, 2025, to December 31, 2027, and the deadline for the DMHC to report findings to the Legislature from January 1, 2027 to January 1, 2029.

1 California HSC sections 1340 et seq. (Act). References herein to “Section” are to sections of the Knox-Keene Act. References to “Rule” refer to the California Code of Regulations, Title 28.

2 Voluntary Employees’ Beneficiary Association is defined at section 1343.3(a).

RFP No. C26MC-0007

The purpose of the pilot program is to demonstrate the control of costs for health care services and the improvement of health outcomes and quality of service when compared against a sole fee-for-service provider reimbursement model. Pursuant to section 1343.3(a)(11)(A), the VEBA must collect and report to the DMHC, in each year of the pilot program, information regarding the comparative cost savings when compared to fee-for-service payment, performance measurements for clinical patient outcomes, and enrollee satisfaction.

C. SCOPE OF WORK

Please refer to Exhibit A – Scope of Work for a detailed breakdown of the services/tasks/deliverables applicable to this RFP.

D. ADMINISTRATIVE REQUIREMENTS

The successful Proposer awarded an Agreement must fulfill the following Administrative Requirements prior to commencing work, and is responsible for any fees or expenses, including time, for completing these items:

1. Information Security, Integrity and Confidentiality Statement Exhibit E-I for Contractor Authorized Representative and Exhibit E-II for project employees, agents or sub-contractors, which certify the Contractor and the Contractor’s staff understand and agree to comply with the DMHC’s Information Security and Confidentiality Statement.

2. Annual Information Security Awareness and Privacy Training California policy requires the DMHC to provide for the proper use and protection of its information assets and arrange for basic security and privacy awareness training (State Administrative Manual sections 5305.1; 5320.1; 5320.2, Statewide Information Management Manual 5330-B) for new users and annually thereafter.

The DMHC contractors (including subcontractors) who access state resources must complete the designated DMHC annual Information Security Awareness and Privacy Training online prior to beginning work on a contract and accessing DMHC information assets. The DMHC Information Security Officer will set up the training account. The training course is free-of-charge; any expenses, including Contractor time, related to Information Security Awareness and Privacy Training are the responsibility of the Contractor. Active contractors/subcontractors must provide a list of their employees’ names and email addresses annually to the DMHC Information Security Officer to administer training.

3. Statement of Economic Interests (Form 700) The California Political Reform Act requires individuals holding positions designated within an agency’s conflict of interest code to file an annual Statement of Economic Interests (Form 700). The DMHC’s conflict of interest code designates “Consultants” among the positions that must file a Form 700. The Contractor’s employees or independent contractors, working on the above-named contract, will be designated as consultants required to file an original Form 700 with the DMHC.

(See Government Code sections 82019 and 87302.)

No Contractor shall participate in the making of, or in any way attempt to influence, a decision in which the Contractor knows, or has reason to know, that it has a financial interest. The Contractor shall notify the DMHC Contract Manager immediately in writing if the Contractor has a potential or actual conflict of interest relating to this Agreement.

The Contractor shall abide by the provisions of Government Code Sections 1090, 81000 et seq., 82000 et seq., 87100 et seq., and 87300 et seq., PCC sections 10335 et seq. and 10410 et seq., California Code of Regulations, Title 2, section 18700 et seq., and the DMHC Incompatible Activities Policy.

Each of the Contractor’s employees assigned to the DMHC project shall file a Statement of Economic Interests, Fair Political Practices Commission Form 700 within 30 days of commencing services under the Agreement, annually during the life of the Agreement, and within 30 days after the expiration of the Agreement.

The Contractor shall have a continuing duty to disclose fully and timely to the DMHC, in writing:

• All interests and activities that create an actual or potential conflict of interest in performance of the Agreement.

• Any material changes in the Contractor’s business name, structure and/or status, including any changes in business ownership and/or form, such as a change from sole proprietorship or partnership into a corporation or vice versa;

dissolution of the business; filing in bankruptcy; revocation of corporate status by the Secretary of State; and other material changes in the Contractor’s business status or structure that could affect the performance of the Contractor’s duties under the Agreement.

If the Contractor violates any disclosure duties, it shall render this Agreement void.

4. Ethics Certification

Government Code sections 11146 through 11146.4 require all officials, employees and contracted consultants designated to file a Form 700 to also complete an Ethics Certification when first assuming a designated position and then every odd numbered year thereafter. If consultants assumed their designated position during an even numbered year, they are required to complete the Ethics Certification two years in a row.

E. PROPOSAL REQUIREMENTS AND INFORMATION

1. Anticipated Key Action Dates

Activity Anticipated Action Date and Time RFP Available to Prospective Proposers June 11, 2026 Last Day for Proposers to Submit Written Questions June 18, 2026 at 4:00 p.m. PDT Answers to Questions Posted June 25, 2026 Proposal Submittal Deadline July 9, 2026 at 4:00 p.m. PDT Cost Proposal Opening July 16, 2026 Notice of Intent to Award July 17, 2026 Proposed Award Date July 23, 2026

Contract Term October 1, 2026, or Upon Approval, whichever is earlier – September 30, 2028

Note: The DMHC may modify this RFP prior to the Proposal Submittal Deadline by issuing and posting a formal addendum to https://caleprocure.ca.gov/.

All dates after the Proposal Submittal Deadline are approximate and may be adjusted as conditions indicate, without an Addendum to this RFP.

2. Submission of Questions

All questions must be submitted in writing prior to 4:00 p.m. PDT on June 18, 2026, to Lesya Vorobets at Contracts.Unit@dmhc.ca.gov. Responses will be posted on https://caleprocure.ca.gov/ under Voluntary Employees’ Beneficiary Association or Trust Fund Consulting Services (C26MC-0007).

All addenda and questions will be posted on https://caleprocure.ca.gov, along with Cal eProcure registration Instructions.

3. General Requirements

a. The Proposer must provide documentation (i.e. Certificate of Good Standing from the California Secretary of State) to substantiate they are in good standing and qualified to conduct business in California.

b. The Proposer must not be an affiliate or a subsidiary of, nor in any way owned or controlled by, a health care service plan or a trade association of health care service plans. A board member, director, officer or employee of the Contractor https://caleprocure.ca.gov/ mailto:Contracts.Unit@dmhc.ca.gov https://caleprocure.ca.gov/ https://caleprocure.ca.gov/ https://caleprocure.ca.gov/pages/bidder-vendor.aspx shall not serve as a board member, director or employee of a health care service plan. A board member, director or officer of a health care service plan or a trade association of health care service plans shall not serve as a board member, director, officer or employee of the Proposer’s firm.

c. The Proposer must not be currently engaged in services with a health care service plan or a trade association of health care service plans in California or any activities that could appear to be a conflict of interest.

4. References

The Proposer is required to provide three references, on Attachment 11, Proposer References, for which the Proposer has provided similar services as described in Section C, Scope of Work. The DMHC retains the right to conduct reference checks beyond those supplied by the Proposer. The DMHC must not be listed as a reference. Proposers must cite other entities with completed work for this requirement.

5. Resumes

The Proposer shall provide resumes for proposed key project personnel (either staff or consultants to the Contractor or subcontractor(s)). The resumes for all key project personnel should demonstrate two years of paid work experience performed in the last five years, similar to the services described in Section C, Scope of Work.

Resumes should list the most recent experience first. Multiple companies may be listed to support key project personnel’s experience. It is the responsibility of the Proposer to clearly describe how the experience meets the requirements.

If, for any reason, the project personnel listed in the original proposal is unable to perform services during the term of the contract, the DMHC retains the right to approve, in advance, any changes to the personnel or terminate the Agreement.

6. Work Plan

The Proposer shall develop a narrative Work Plan, labeled Attachment 13, Work Plan, for task completion outlining their ability to fulfill the requested services as identified in Section C, Scope of Work. The Work Plan must include the following:

a. Proposer Qualifications

Provide a detailed description of Proposer’s qualifications, skills, knowledge and expertise related to California health plans and the overall healthcare market. Describe its current and past experience with:

• Working with the health insurance industry (e.g., Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs) and medical groups), government and non-profit health entities in California.

• Reviewing comparative health care cost savings and relevant market, financial and operational data of health care entities; and reviewing clinical patient outcomes.

• Analyzing performance measurements for the clinical patient outcomes in accordance with Integrated Healthcare Association’s AMP program and the California Regional Health Care Cost and Quality Atlas.

• Fee-For-Service vs Capitated Payment models.

b. Project Personnel

A detailed plan estimating the classifications and number of individuals and different teams, responsible for performing the requested services mentioned in Section C, Scope of Work, and any administrative functions such as collecting and submitting the necessary forms for each employee for statements of economic interest.

Provide a description of the key project personnel and anticipated supporting personnel to be employed during contract performance by name, classification/title and their qualifications to perform the work.

If subcontractors are contemplated, identify those persons or firms, the portions of the work to be done by the subcontractors, and how and why they were selected. Provide a description of how subcontracted work will be controlled, monitored and evaluated.

c. Project Description

A detailed description of the techniques and methods to be used in performing the services described in Section C, Scope of Work, including:

• Developing the reporting template utilized by the pilot project participant(s) for annual reporting.

• Reviewing comparative cost savings and relevant market, financial and operational data.

• Reviewing clinical patient outcomes information submitted by the pilot project participant.

• Reviewing enrollee satisfaction metrics.

• Reviewing comparative cost savings and clinical patient outcome and enrollee satisfaction performance measures in accordance with Integrated

Healthcare Association’s AMP program and the California Regional Health Care Cost and Quality Atlas.

• Collaborating and coordinating with the DMHC and the VEBA appointed ombudsperson in the review and consideration of complaints lodged by participating enrollees.

• Meeting intermediate and completion timeframes.

• Preparing the legislative report at the completion of the pilot project.

d. Work Samples

The Proposer shall provide one work sample created for similar project(s) within the last five years to demonstrate:

• Ability to evaluate health care financial/cost savings analysis.

• Ability to evaluate clinical patient outcomes.

• Familiarity with Integrated Healthcare Association’s AMP program and the California Regional Health Care Cost and Quality Atlas.

• Ability to evaluate health care financial/cost savings, clinical patient outcomes and performance measurements.

• Analytical approach to financial/cost savings and/or clinical patient outcomes from inception to completion.

• Final report sample with analysis, findings and recommendations.

e. Financial Stability

The Proposer shall submit a written statement regarding the Proposer’s financial and organizational stability; how long the Proposer has been in business; if the Proposer is nationwide or local; the number of years the Proposer has performed services similar to the services mentioned in Section C, Scope of Work; and, any probable contingencies that may affect the Proposer’s financial and organizational stability.

f. Conflict of Interest

The Proposer shall provide a detailed description of how the Proposer will monitor for potential conflicts of interest that may preclude it from accepting work assignments from the DMHC. The description should include criteria to determine a conflict of interest and timeframe for notifying the DMHC after a conflict of interest has been identified. The Proposer must also include their policy and procedures for monitoring conflicts of interest. If the Proposer does not have a policy, they must provide an explanation of how they monitor for potential conflicts of interest.

The Proposer is responsible for identifying all additional information and/or resources (facilities, equipment, network connectivity, etc.) it deems necessary from the DMHC to successfully complete all deliverables, activities or tasks detailed in Section C, Scope of Work.

7. Proposal Format and Requirements

a. Proposals should provide straight-forward and concise descriptions of the Proposer’s ability to perform the requirements of this RFP. The proposal must be complete and accurate. Omissions, inaccuracies or misstatements may be cause for rejection of a proposal.

b. Proposals must be submitted for the performance of all the services described herein. Any deviation from the work specifications will not be considered and may cause a proposal to be rejected. A proposal may be rejected if it is conditional or incomplete, or if it contains any alterations of any form or other irregularities of any kind. The State may reject any or all proposals and may waive an immaterial deviation in a proposal. [The State’s waiver of an immaterial deviation shall in no way modify the RFP document or excuse the Proposer from full compliance with all requirements if awarded the Agreement.]

c. The Proposer must complete Attachment 14, Cost Proposal, in the prescribed format. Any deviation from the prescribed format, which in the opinion of the DMHC is material, may result in the rejection of the proposal. The proposed cost shall include all fees and expenses for providing services described in this RFP. The successful organization shall only be compensated based on actual services performed at the rates submitted.

d. All pricing shall remain firm and constant during the entire Agreement term, including any extensions or amendments.

e. All proposals shall include the documents identified in Attachment 1, Required Document Checklist. Proposals not including the Attachments listed below shall be deemed non-responsive. A non-responsive proposal is one that does not meet the basic proposal requirements. All proposals must include the following Attachments:

i. Attachment 1, Required Document Checklist

ii. Attachment 2, Proposal/Proposer Certification Sheet

iii. Attachment 3, Bidder Declaration

iv. Attachment 4, DVBE Incentive Application Request (If Applicable)

v. Attachment 5, Darfur Contracting Act Certification (If Applicable)

vi. Attachment 6, California Civil Rights Laws Certification https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/GSPD05-106.pdf https://www.dgs.ca.gov/-/media/CBAFDC111B6C43B09496B8391E11F394.ashx https://www.dgs.ca.gov/-/media/Divisions/OLS/Forms/CALIFORNIA-CIVIL-RIGHTS-LAWS-ATTACHMENT.ashx

vii. Attachment 7, Contractor Certification Clauses

viii. Attachment 8, Iran Contracting Act

ix. Attachment 9, Payee Data Record

x. Attachment 10, Certificate of Good Standing

xi. Attachment 11, Proposer References

xii. Attachment 12, Resumes

xiii. Attachment 13, Work Plan

xiv. Attachment 14, Cost Proposal

f. An individual who is contractually authorized to bind the proposing organization shall sign Attachment 2, Proposal/Proposer Certification Sheet. The signature must indicate the title or position the individual holds in the organization. An unsigned proposal may be rejected.

g. If the proposal is made under a fictitious name or business title, the actual legal name of the Proposer must be provided.

h. More than one proposal from an individual, firm, partnership, corporation or association under the same or different names, will not be considered.

i. Joint proposals are not acceptable. A joint proposal is when two or more Proposers sign and submit a proposal together for requested services.

j. All pages of the proposal shall have the following header and consecutive page numbering format in the upper right-hand corner:

(Proposer’s Legal Name)

RFP #C26MC-0007

Voluntary Employees’ Beneficiary Association or Trust Fund Consulting Services

8. Electronic Submission Instructions

a. Hard copy proposals will not be accepted for this solicitation. If a Proposer requires any reasonable accommodations, email requests to Contracts.Unit@dmhc.ca.gov.

b. The entire proposal, except Attachment 14, Cost Proposal, must be emailed to ElectronicBidSubmissions@dmhc.ca.gov with the following subject line: RFP C26MC-0007 [Proposer’s Name] Proposal.

c. Attachment 14, Cost Proposal, must be sent in a separate email to ElectronicBidSubmissions@dmhc.ca.gov with the following subject line: RFP C26MC-0007 [Proposer’s Name] Cost Proposal - DO NOT OPEN https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf?la=en&hash=4DE3E4DC414511AE378794200BA43EBF91C758EE https://www.dgs.ca.gov/-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/Iran-Contracting-Act.pdf http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf mailto:Contracts.Unit@dmhc.ca.gov mailto:ElectronicBidSubmissions@dmhc.ca.gov

d. Both emails must be received by the DMHC by 4 p.m. PDT, July 9, 2026.

Proposals received after this time and date will not be considered.

e. Proposals sent with Attachment 14, Cost Proposal in the same email submission and/or to any other email address(es) other than ElectronicBidSubmissions@dmhc.ca.gov may be rejected. If a proposal is inadvertently sent to an incorrect email address, Proposer must take all appropriate corrective steps to avoid proposal rejection.

f. Files stored on the Internet (e.g., Google Drive, Dropbox, etc.) in lieu of attachments are not acceptable. Any documents stored at such links will not be retrieved. Zip files are acceptable and encouraged.

g. If multiple emails are required due to file size, they should be identified in the subject line as follows: 1 of 2, 2 of 2 etc.

h. Emails containing Cost Proposals will be opened by the DMHC during Stage 2: Cost Proposal Evaluation as described in section E. Proposal Requirements and Information, item 10. Evaluation Process and Criteria.

i. A Proposer may modify a proposal after submission by withdrawing its original proposal and resubmitting a new proposal prior to the proposal submission deadline as set forth in Section E, Proposal Requirements and Information, Item 1, Anticipated Key Action Dates. Proposal modifications offered in any other manner, oral or written, will not be considered.

j. A Proposer may withdraw its proposal by emailing withdrawal request to the DMHC, signed by the Proposer or an authorized agent for the organization.

Once the DMHC has confirmed acceptance and approval of the withdrawal request, the Proposer may then submit a new proposal prior to the proposal submission deadline. Subsequent to proposal submission deadline, proposals may not be withdrawn without cause.

k. Email the withdrawal request to Contracts.Unit@dmhc.ca.gov including a subject line: Withdrawal RFP #C26MC-0007.

l. The Proposers are cautioned to not rely on the DMHC during the evaluation to discover and report to the Proposer any defects and errors in the submitted documents. Proposers, before submitting their documents, should carefully proof them for errors and adherence to the RFP requirements.

m. In submitting a proposal, the Proposer authorizes the DMHC to verify any or all claimed information, proprietary or non-proprietary, by any reasonable means, including onsite inspection, and any references named in their proposal.

n. Costs incurred for developing proposals and in anticipation of award of an Agreement, are entirely the responsibility of the Proposer and shall not be charged to the State of California.

o. The DMHC reserves the right to reject all proposals and is not required to award an Agreement.

p. No oral understanding or Agreement shall be binding on either party.

9. Disposition of Proposals

a. Upon proposal opening, all documents submitted in response to this RFP will become the property of the State of California and regarded as public records under the California Public Records Act (Government Code Section 7920, et.

seq.) and subject to review by the public.

10. Evaluation Process and Criteria

a. At the time of proposal opening, each proposal will be checked for the presence or absence of the required information in conformance with the submission requirements of this RFP. A responsive proposal is one which meets or exceeds the requirements stated in this RFP.

b. Proposals that contain false or misleading statements or provide references which do not support an attribute or condition claimed by the Proposer may be rejected.

c. Proposers claiming any of the proposal preferences shall submit the proper required certification documents and check the box next to the applicable Attachment number on Attachment 1, Required Document Checklist. Refer to the links in Section F, Preference Programs, in this RFP for information regarding these preference programs.

Evaluation Criteria are set as follows:

Stage 1: Evaluation

The proposals that meet the submission requirements of this RFP will be evaluated and scored according to the criteria indicated below. A minimum of 63 points must be achieved in this phase to be considered responsive. (A responsive proposal meets or exceeds the requirements stated in this RFP.)

Evaluation Criteria (90 maximum points) Maximum Possible

Score

A. Proposer Qualifications

Clearly and thoroughly demonstrates requested qualifications and experience = 10 points

Response is adequate but does not completely address the requirement = 5 points

Response does not meet the requirement = 0 points

The Proposer's past and current experience with:

i. Working with the health insurance industry (e.g., HMOs, PPOs and medical groups), government and non-profit health entities in California.

ii. Reviewing comparative health care cost savings and relevant market, financial and operational data of healthcare entities;

and reviewing clinical patient outcomes.

iii. Analyzing performance measurements for the clinical patient outcomes in accordance with Integrated Healthcare Association’s AMP program and the California Regional Health Care Cost and Quality Atlas.

iv. Fee-For-Service vs Capitated Payment models.

B. Project Personnel

Clearly and thoroughly demonstrates ability to meet the requested services with the project personnel identified = 10 points

Response is adequate but does not completely address the requirement = 5 points

Resumes for all key project personnel and work plan submitted by the proposer demonstrate experience in fulfilling the requested services as identified in Section C, Scope of Work

Possible

Score

C. Project Description

Clearly and thoroughly documents the requirement = 5 points

Response is acceptable but does not completely address the requirement = 3 points

Methods used to develop the reporting template utilized by the pilot project participant(s) for annual reporting. 5

Techniques to review the comparative cost savings and relevant market, financial and operational data. 5

Techniques to review clinical patient outcomes information submitted by the pilot project participant. 5

Techniques to review enrollee satisfaction metrics. 5

Techniques to review comparative cost savings and clinical patient outcome and enrollee satisfaction performance measures in accordance with Integrated Healthcare Association’s AMP program and the California Regional Health Care Cost and Quality Atlas.

Methods for collaborating and coordinating with the DMHC and the VEBA appointed ombudsperson in the review and consideration of complaints lodged by participating enrollees.

Methods for meeting intermediate and completion timeframes. 5

Methods for preparing the legislative report at the completion of the pilot project. 5

Possible

Score

D. Work Samples

Clearly and thoroughly demonstrates requested work experience = 20 points

Response is adequate but does not completely address the requirement = 10 points

Proposer’s work sample created for a similar project to demonstrate:

• Ability to evaluate health care financial/cost savings analysis.

• Ability to evaluate clinical patient outcomes.

• Familiarity with Integrated Healthcare Association’s AMP program and the California Regional Health Care Cost and Quality Atlas.

• Ability to evaluate health care financial/cost savings, clinical patient outcomes and performance measurements.

• Analytical approach to financial/cost savings and/or clinical patient outcomes from inception to completion

• Final report sample with analysis, findings and recommendations

E. Financial Stability

Clearly and thoroughly documents the requirement = 5 points

Response is acceptable but does not completely address the

A written statement on financial and organizational stability. 5

Possible

Score

F. Conflicts of Interest

Clearly and thoroughly documents the requirement = 5 points

Response is acceptable but does not completely address the

The Proposer's methodology for monitoring potential conflicts. 5

Total Possible Points 90

Stage 2: Cost Proposal Evaluation

i. This phase consists of evaluating the cost proposals. All proposals that enter Stage 2 will have received 63 points or more and are considered fully capable of performing the required services.

ii. Submittals containing proposal cost information that meet the format requirements and standards shall then be publicly opened in a virtual forum and read.

iii. Email Contracts.Unit@dmhc.ca.gov prior to 5 p.m. July 15, 2026 to attend the virtual Cost Proposal Opening.

iv. The Agreement will be awarded to the lowest cost responsible Proposer meeting the requirements outlined in this RFP.

11. Award and Protest

a. Notice of the proposed award shall be posted in the DMHC lobby at 9646 Butterfield Way, Sacramento, California and at http://www.dmhc.ca.gov for five days prior to award of the Agreement.

b. If any Proposer, prior to Agreement award, files a protest with the DMHC and the DGS, Office of Legal Services, 707 Third Street, 7th Floor, Suite 7-330, West Sacramento, CA 95605 (OLSProtests@dgs.ca.gov), on the grounds the protesting Proposer would have been awarded the Agreement had the DMHC mailto:Contracts.Unit@dmhc.ca.gov http://www.dmhc.ca.gov/ mailto:OLSProtests@dgs.ca.gov evaluated and scored their proposal as described in the RFP, the Agreement shall not be awarded until the protest has been withdrawn or DGS decided the matter. It is suggested any protest is sent by certified or registered mail.

c. Within five days after filing the initial protest, the protesting Proposer shall file with the DGS, Office of Legal Services and the DMHC a detailed statement specifying the grounds for the protest. The protest must be submitted to the address listed in Item b, above.

d. Upon resolution of any filed protest and Agreement award, Contractor must submit a completed Payee Data Record (STD 204) to determine if the Contractor is subject to state income tax withholding pursuant to the California Revenue and Taxation Code Sections 18662 and 26131. No payment shall be made unless a completed STD 204 has been returned to the DMHC.

e. Upon resolution of any filed protest and Agreement award, the Contractor must sign and submit the Contractor Certification Clauses (CCC 04/2017).

12. Agreement Execution and Performance

a. Performance shall start on the express date set by the DMHC and the Contractor, after all approvals have been obtained and the Agreement is fully executed. In addition, the Contractor must fulfill the Administrative Requirements prior to commencing work on the Agreement. Should the Contractor fail to commence work at the agreed upon time, the DMHC, upon five days written notice to the Contractor, reserves the right to terminate the Agreement.

b. The State’s General Terms and Conditions (GTC 02/2025) are not negotiable.

The DMHC does not accept alternate Agreement language from a Contractor.

A proposal with such language will be considered a counter proposal and will be rejected.

c. All performance under the Agreement shall be completed on or before the termination date of the Agreement.

F. PREFERENCE PROGRAMS

The standard Agreement language for the preference programs applied to this RFP can be found at the Internet websites listed below:

1. Small Business (SB) Preference https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std811.pdf.

2. Non-SB Subcontractor Preference https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf.

https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std204.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/GTC-Updates/GTC-225-February-2025.pdf https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std811.pdf https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

3. Target Area Contract Preference Act https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf.

If applying for one of these preference programs, please be sure to complete and submit the required documents, which can be found at the above links.

G. DISABLED VETERAN BUSINESS ENTERPRISE INCENTIVE PROGRAM

Note: The DVBE participation requirement has been waived; however, the DVBE Incentive Program will apply for this solicitation.

Under CCR Title 2, Section 1896.99.100, the California DVBE Incentive provides responsive and responsible organization the opportunity to receive additional incentive calculations. The incentive is applied at the time of solicitation evaluation when a proposing organization selects a California-certified DVBE subcontractor to provide services or commodities in support of the overall contract effort. Application of the DVBE Incentive may place the proposing organization in line for contract award.

The DVBE Incentive is applied during the evaluation process and is only applied to responsive proposals from responsible organizations proposing the percentage(s) of DVBE participation for the incentive(s) specified in the solicitation.

The following are key elements of the DVBE Incentive Program:

1. The DVBE Incentive participation is optional and at the discretion of the proposing organization.

2. When requesting the Incentive Application, proposing organizations must complete and return Attachment 4, DVBE Incentive Application Request with their proposal at time of submission.

3. The incentive is applied by reducing the cost proposed by the amount of incentive as computed from the lowest responsive and responsible proposal. Computation is for evaluation purposes only. (2 CCR 1896.99.100 (c)).

4. Services or commodities provided by the DVBE firm MUST meet the definition of a “Commercially Useful Function” (CUF) as defined under Government Codes Section 14837(d)(4) and Military and Veterans Code Section 999(b)(5)(B). A DVBE firm not meeting CUF regulations will render the proposing organization ineligible for the DVBE Incentive application.

5. The DVBE Incentive application will be based on the Low Cost Method and follows the guidelines identified below:

Application of the incentive is based on the proposing firm’s level of DVBE participation identified (1- 5% and higher).

https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std830.pdf

a. For awards based on low cost, the incentive is applied by reducing the cost proposed by the amount of incentive as computed from the lowest responsive and responsible proposal. (2 CCR 1896.99.100 (c)).

SAMPLE: Using the incentive scale below (Display is for illustration purposes only).

b. Order of Evaluation:

i. SB Preference is calculated by multiplying the lowest Proposed Price of a

Non-SB by five percent and deducting the resulting calculation from the Proposed Price of the certified SB firm(s). In the sample above, the calculation was based on $100,000 x .05 resulting in $5,000 being deducted from the certified SBs (Firms B and C) Proposed Price.

ii. The DVBE Incentive is calculated by multiplying the lowest Proposed Price of a Non-SB by the Confirmed DVBE Participation percentage. This amount is then deducted from the firm’s Proposed Price Subtotal. In the sample above, Firm B had $3,000 ($100,000 x 0.3) deducted from its Proposed Price Subtotal. Firm C had $5,000 ($100,000 x 0.5) deducted from its Proposed Price Subtotal placing it first for award.

Confirmed DVBE Participation

Incentive Applied:

1 - 1.99% inclusive 1% 2 - 2.99% inclusive 2% 3 - 3.99% inclusive 3% 4 - 4.99% inclusive 4%

5% and Higher 5%

SAMPLE RESULTS PROPOSER A PROPOSER B PROPOSER C

Responsive/Responsible Yes Yes Yes

Proposed Price $100,000 $102,000 $103,000 Rank 1 2 3

SB Eligible Preference None SB SB Eligible Preference $0 $5,000 $5,000

Proposed Price Subtotal $100,000 $97,000 $98,000 New Rank 3 1 2

Confirmed DVBE Participation None (0%) Yes (3%) Yes (5%) Confirmed DVBE Participation

Incentive Amount $0 $3,000 $5,000

Net Proposal Amount (For Evaluation Purposes Only)

$100,000 $94,000 $93,000

New Rank 3 2 1

iii. Under the DVBE Incentive method, it is possible to displace a Certified SB with the application of the DVBE incentive.

H. NEWS RELEASES AND SOCIAL MEDIA

Proposers must obtain prior written approval from the DMHC before issuing any news release, statement to the news media or social media post(s) pertaining to this RFP.

I. EXECUTIVE ORDER N-6-22 – RUSSIA SANCTIONS

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. By submitting a bid or proposal, Contractor represents that it is not a target of Economic Sanctions. Should the State determine Contractor is a target of Economic Sanctions or conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for rejection of the Contractor’s bid/proposal any time prior to contract execution, or, if determined after contract execution, shall be grounds for termination by the State.

J. EXECUTIVE ORDER N-12-23 – GENERATIVE ARTIFICIAL INTELLIGENCE

The State of California seeks to realize the potential benefits of Generative Artificial Intelligence (GenAI), through the development and deployment of GenAI tools, while balancing the risks of these new technologies.

Proposer must notify the State in writing if it: (1) intends to provide GenAI as a deliverable to the State; or (2), intends to utilize GenAI, including GenAI from third parties, to complete all or a portion of any deliverable that materially impacts: (i) functionality of a State system, (ii) risk to the State, or (iii) Contract performance. For avoidance of doubt, the term “materially impacts” shall have the meaning set forth in State Administrative Manual section 4986.2 Definitions for GenAI.

Failure to report GenAI to the State may result in disqualification. The State reserves the right to seek any and all relief to which it may be entitled to as a result of such non-disclosure.

Upon notification by a Proposer of GenAI as required, the State reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present an unacceptable level of risk to the State.

Government Code section 11549.64 defines “Generative Artificial Intelligence (GenAI)” as an artificial intelligence system that can generate derived synthetic content, including text, images, video, and audio that emulates the structure and characteristics of the system’s training data.

https://www.gov.ca.gov/wp-content/uploads/2022/03/3.4.22-Russia-Ukraine-Executive-Order.pdf

K. ATTACHMENTS

ATTACHMENT 1

REQUIRED DOCUMENT CHECKLIST

Proposer’s Name:

A complete proposal package consists of all required items listed in the RFP and identified below. Place an “X” next to each Attachment you are submitting to the State.

For the proposal to be considered responsive, all required Attachments must be submitted with this checklist on top.

Checklist

Included

Attachment Number Attachment Name / Description

Form / Documentation

Required 1 Required Document Checklist Yes 2 Proposal/Proposer Certification Sheet Yes 3 Bidder Declaration Yes 4 DVBE Incentive Application Request If Applicable 5 Darfur Contracting Act Certification If Applicable

6 California Civil Rights Laws Certification Yes

7 Contractor Certification Clauses Yes 8 Iran Contracting Act Yes 9 Payee Data Record Yes 10 Certificate of Good Standing Yes 11 Proposer References Yes 12 Resumes Yes 13 Work Plan Yes 14 Cost Proposal Yes

I attest my organization is financially stable and able to provide the services referenced in this RFP. I acknowledge my responsibility to promptly notify the DMHC of changes that may impact my organization’s ability to fulfill the services referenced in this RFP.

Signature:

Printed Name of Person Signing:

Date:

ATTACHMENT 2

PROPOSAL/PROPOSER CERTIFICATION SHEET

(Page 1 of 2)

This sheet must be signed and returned along with all the Required Attachments and must bear an original signature of someone authorized to bind your organization contractually.

The signature affixed hereon and dated certifies compliance with all the requirements of this proposal document. The signature below authorizes the verification of this certification.

An Unsigned Proposal/Proposer Certification Sheet May Be Cause for Rejection

1.Organization/Company

2. Telephone Number 2a. Fax Number

3. Address

Indicate your organization type:

4. Sole Proprietorship 5. Partnership 6. Corporation Indicate the applicable employee and/or corporation number:

7. Federal Employee ID No.

8. California Corporation No.

9. Indicate applicable license and/or certification information:

10. Proposer’s Name (Print) 11. Title

12. Signature 13. Date

14. Are you certified with the Department of General Services, Office of Small Business and Disabled Veteran Certification (OSDC) as:

a. Small Business Enterprise Yes No

If yes, enter certification number:

b. Disabled Veteran Business Enterprise Yes No

If yes, enter your service code below:

NOTE: A copy of your Certification is required to be included if either of the above items is checked “Yes”.

Date application was submitted to OSDC, if an application is pending:

ATTACHMENT 2

(Page 2 of 2)

Instructions for Proposal/Proposer Certification Sheet: Complete the numbered items on the Proposal/Proposer Certification Sheet by following the instructions below.

Item Numbers

Instructions

1, 2, 2a, 3 Must be completed. These items are self-explanatory.

Check if your firm is a sole proprietorship. A sole proprietorship is a form of business in which one person owns all the assets of the business in contrast to a partnership and corporation. The sole proprietor is solely liable for all the debts of the business.

Check if your firm is a partnership. A partnership is a voluntary agreement between two or more competent persons to place their money, effects, labor and skill, or some or all of them in lawful commerce or business, with the understanding there shall be a proportional sharing of the profits and losses between them. An association of two or more persons to carry on, as co-owners, a business for profit.

Check if the firm is a corporation. A corporation is an artificial person or legal entity created by or under the authority of the laws of a state or nation, composed, in some rare instances, of a single person and his successors, being the incumbents of a particular office, but ordinarily consisting of an association of numerous individuals.

7 Enter your Federal Employee Tax Identification Number.

Enter your corporation number assigned by the California Secretary of State’s Office. This information is used to check if a corporation is in good standing and qualified to conduct business in California.

9 Indicate applicable license and/or certification information that your firm possesses and that is required for the type of services being procured.

10, 11, 12, 13 Must be completed. These items are self-explanatory.

If certified as a Small Business Enterprise, place a check in the "yes" box, and enter your certification number on the line. If certified as a Disabled Veteran Business Enterprise, place a check in the "Yes" box and enter your service code on the line. If you are not certified, place a check in the "No" box. If your certification is pending, enter the date your application was submitted to OSDC.

ATTACHMENT 3

BIDDER DECLARATION

To view the form, click on the heading. Contact Contracts.Unit@dmhc.ca.gov to request a hard copy.

https://www.dgs.ca.gov/-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/master-biddeclar08-09.pdf https://www.dgs.ca.gov/-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/master-biddeclar08-09.pdf

ATTACHMENT 4

DVBE INCENTIVE APPLICATION REQUEST

Under the DVBE Incentive Regulations, CCR Title 2, Section 1896.99.100, I request the application of the DVBE Program Incentive to RFP C26MC-0007 to determine if my firm may be in line for bid award.

a. I understand that the DVBE Incentive application will be applied using the “Low Cost Method” and cannot be used to achieve any applicable minimum point requirements.

b. I understand the DVBE firm(s) selected must provide a “Commercially Useful Function” as required under Government Codes 14837(d)(4) and Military and Veterans Code 999(b)(5)(B).

c. I understand I will be required to report my firm’s DVBE activities quarterly to the DMHC Contract Unit.

d. I understand that subsequent amendments to the Agreement may require continued use of the identified DVBE firm if that contract amendment adds additional funding for continued services.

e. As the Proposing firm, I identify the following percentage of DVBE participation for this solicitation: ____ percent.

SECTION A - PROPOSING FIRM INFORMATION

Name:

Representative:

Title:

Address:

City: State: Zip:

Telephone:

Email:

SECTION B - PROPOSED DVBE FIRM

DVBE Name:

Representative:

Title:

Address:

City: State: Zip:

Telephone: Fax:

Email:

DVBE Certification:

DGS OSDS No.: Date of Expiration:

Services to be Performed:

Proposer Instructions:

1. Complete information in Section A.

2. Send this form to DVBE firm(s) to complete Section B.

3. Instruct the DVBE firm(s) to provide a copy of their DGS Office of Small Business and

DVBE Services certification.

4. This form must be included with your proposal to be considered for the DVBE Incentive application.

ATTACHMENT 5

DARFUR CONTRACTING ACT CERTIFICATION

https://www.dgs.ca.gov/-/media/CBAFDC111B6C43B09496B8391E11F394.ashx

ATTACHMENT 6

CALIFORNIA CIVIL RIGHTS LAWS CERTIFICATION

https://www.dgs.ca.gov/-/media/Divisions/OLS/Forms/CALIFORNIA-CIVIL-RIGHTS-LAWS-ATTACHMENT.ashx

ATTACHMENT 7

CONTRACTOR CERTIFICATION CLAUSES

https://www.dgs.ca.gov/-/media/Divisions/OLS/Resources/CCC-042017.pdf?la=en&hash=4DE3E4DC414511AE378794200BA43EBF91C758EE

ATTACHMENT 8

IRAN CONTRACTING ACT

To view the form, click on the heading. Contact Contracts.Unit@dmhc.ca.gov to request a hard copy.

https://www.dgs.ca.gov/-/media/Divisions/PD/PTCS/OPPL/SCM/SCM-Link-Docs/Iran-Cont…