Exhibit_13_-_Technical_Solution_and_Architecture.docx

Exhibit 13 – Technical Solution and EDE Architecture

Purpose This Exhibit evaluates the strength, scalability, resilience, and sustainability of Bidder’s proposed technical solution and its ability to support a State-Based Exchange operating under an EDE-first operating model that includes both Oklahoma Enrollment Partners (OKEPs) and a State-operated consumer portal utilizing shared Exchange services.

general instructions

· Page Limit: 26 Pages

· Font: Minimum 11-point (Arial, or Calibri)

· Margins: Minimum 1 inch

· Line spacing: Single or 1.15

· Tables and diagrams are encouraged and count toward page limits

· Avoid marketing language; focus on architecture, design decisions, and execution details

· All content within each Exhibit, including bidder instructions, narrative responses, tables, and supporting detail, shall count toward the applicable page limitations unless otherwise specified.

Response expectations The Bidder shall describe:

Overall Technical Architecture Bidder Instructions: Overall Technical Architecture Bidder should describe the overall system architecture supporting the Exchange.

Include:

· High-level architecture, including major system components and their interactions

· Hosting model (e.g., cloud provider, environments, tenancy model)

· Description of modularity and extensibility of the solution

· Approach to supporting multiple enrollment channels, including OKEPs and a consumer portal, through shared Exchange services

· Approach to modular architecture supporting future operational flexibility and evolving enrollment channel strategies

· Approach to system resiliency, fault tolerance, and disaster recovery

· Environment strategy (e.g., development, test, UAT, production)

Bidder Response: Overall Technical Architecture In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

EDE-First Solution Architecture Bidder Instructions: EDE Solution Architecture Bidder should describe how the proposed solution supports the Exchange’s EDE-first operating model, including both distributed enrollment through OKEPs and direct enrollment through a consumer portal. This should include how data is managed across multiple entities.

Include:

· End-to-End Workflow and Data Ownership

· How core Exchange functions (e.g., eligibility, enrollment, plan selection) are supported within an EDE ecosystem

· Role of the State platform relative to OKEPs and issuer systems

· How the solution enables and supports EDE partners (e.g., onboarding, certification, ongoing integration)

· How shared eligibility, enrollment, workflow, account management, and integration services are utilized across OKEPs and a consumer portal

Bidder Response: EDE Solution Architecture In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

Consumer Experience Across Enrollment Channels Bidder Instructions: Consumer Experience Across EnrollmentChannels Bidder should describe the consumer’s journey and experience as they navigate across different enrollmentchannels and platforms.

Include:

· Consumer journey across a consumer portal, OKEPs, issuers, and other related enrollment channels

· Handling of transitions between systems and partners

· Approach to maintaining consistency in eligibility results, plan data, and enrollment outcomes

· Support for multi-portal interactions and updates

· Approach to maintaining consistent and secure consumer experience across a consumer-facing portal and OKEP channels

Bidder Response: Consumer Experience Across EDE Channels In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

Integration Approach (CMS, FDSH, Medicaid, Issuers, OKEPs) Bidder Instructions: Integration Approach Bidder should describe the integration strategy across all required internal and external systems.

Include:

· Integration approach for CMS systems and federal data services (e.g., FDSH)

· Integration strategy supporting interoperability between a consumer portal and OKEPs

· Integration with State systems, including Medicaid

· Integration with issuer systems

· Integration with OKEPs

· Use of APIs, file-based exchanges, and orchestration mechanisms

· Detailed error handling, retry logic, and failure recovery strategies

· Approach to cross-system reconciliation, including detection and resolution of discrepancies between CMS, issuers, and OKEPs

· Approach to managing external dependencies and integration performance

Bidder Response: Integration Approach In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

Data Management and Data Migration Approach Bidder Instructions: Data Management and Data Migration Approach Bidder should describe how data will be managed, governed, and migrated.

Include:

· Data architecture and data flow across the ecosystem

· Approach to data governance, quality, and validation

· Data migration strategy, including sequencing, validation, and reconciliation

· Approach to maintaining consistent consumer and enrollment data across multiple enrollment channels

· Approach to maintaining data integrity across multiple integrated systems

· Ongoing data reconciliation across issuers, CMS, and OKEPs post-enrollment

· Handling of sensitive data, including PII and FTI

Bidder Response: Data Management and Data Migration Approach In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

Interoperability and API Strategy Bidder Instructions: Interoperability and API Strategy Bidder should describe how the solution enables interoperability across systems and partners.

Include:

· API design standards and architecture (e.g., REST, event-driven, etc.)

· Approach to API lifecycle management, including versioning and change management

· Partner onboarding and certification process (OKEPs and issuers)

· Availability of sandbox and testing environments for partners

· Documentation and support model for API consumers

· Approach to ensuring secure and scalable API usage

· Monitoring and management of API performance and usage

· Approach to supporting shared APIs and reusable services across OKEPs and a consumer portal

Bidder Response: Interoperability and API Strategy In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

Performance, Scalability, and Availability Bidder Instructions: Performance, Scalability, and Availability Bidder should describe how the solution will meet performance and availability requirements.

Include:

· Approach to handling peak loads (e.g., Open Enrollment, Special Enrollment Periods)

· Scalability model (e.g., horizontal/vertical scaling, auto-scaling)

· Availability targets and redundancy approach

· Proposed performance benchmarks (e.g., response times, throughput)

· Assumptions for peak volume and transaction load

· Monitoring thresholds, alerting triggers, and incident response approach

· Performance testing and validation approach

· Operational Readiness and Go-Live Validation

Bidder Response: Performance, Scalability, and Availability In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

System Monitoring and Technical Operations Bidder Instructions: System Monitoring and Technical Operations Bidder should describe how the solution will be monitored and supported in production.

Include:

· Monitoring tools and approach for system health, performance, and availability

· Logging and observability strategy

· Incident detection, triage, and resolution processes

· Approach to proactive issue identification and prevention

· Operational reporting and dashboards

· Support for analytics and reporting capabilities

Bidder Response: System Monitoring and Technical Operations In this section, the Bidder shall provide its written response to the instructions stated above. The response will be evaluated in accordance with this Exhibit.

REQUIRED ARTIFACTS

The Bidder shall also include the following:

· High-level system architecture diagram (required)

· Enrollment channel interaction diagram illustrating the relationship between a consumer portal, OKEPs, issuers, CMS systems, and shared Exchange services (required) Integration architecture diagram (optional but strongly encouraged) 2 | Page image1.png