Exhibit_3_-_Statement_of_Work.docx
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- Attached to
- EDE-first State Based Exchange
- Solicitation number
- EV00000956
- Issued by
- Oklahoma
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Summary
This Statement of Work (Exhibit 3) outlines the comprehensive scope of services for Oklahoma's transition from the Federally Facilitated Exchange (FFE) to a State-Based Exchange (SBE) operation under the Oklahoma Insurance Department (OID). The procurement seeks a single qualified supplier to design, implement, and operate an EDE-first (Enrollment Directly with Enrollment Entity) State-Based Exchange solution beginning with Plan Year 2028, with Open Enrollment occurring in 2027. The supplier will deliver a fully integrated technology platform supporting eligibility governance, enrollment orchestration, case management, issuer coordination, and regulatory reporting within a distributed partner ecosystem leveraging Oklahoma Enrollment Partners (OKEPs) as the primary enrollment channel while maintaining a compliant state consumer portal. The implementation lifecycle is structured across three phases: Design, Development, and Implementation (DDI); Technology Transition (TT); and Maintenance and Operations (M&O). The anticipated contract term begins August 2026 and extends through July 2027, with up to four (4) optional annual renewals subject to State approval. Based on Plan Year 2026 enrollment metrics, Oklahoma processed 219,383 submitted applications resulting in 261,887 plan selections, with approximately 74.5 percent facilitated through agents or brokers.
The supplier must deliver a secure, scalable, modular architecture supporting integration with federal systems (Centers for Medicare & Medicaid Services Data Services Hub), state agencies (Oklahoma Health Care Authority), qualified health plan issuers, and external partners while maintaining State ownership and control of the hosting environment and underlying infrastructure. The solution must comply with applicable Oklahoma Office of Management and Enterprise Services (OMES) standards, policies, and security requirements, along with federal requirements under the Affordable Care Act and 45 C.F.R. Part 155. The supplier shall establish a Service Center functioning as Tier 2 support, manage outbound consumer communications and notices, support document processing and appeals, and provide comprehensive EDE partner integration and support services. All proposals must be structured according to the submission requirements matrix and will be evaluated using standardized scoring criteria. The cost proposal must include all expenses for implementation, technology transition, and ongoing maintenance and operations, reflecting the EDE-first operating model including consumer portal capabilities and shared Exchange services. A warranty period of no less than 90 calendar days follows production implementation, during which the supplier shall provide defect correction, remediation support, and integration validation at no additional cost.
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Exhibit 3 – Statement of Work
Contents
| 1.0 | Project Description | 2 |
| 1.1 | Scope of Procurement | 2 |
| 1.2 | Program Overview and Objectives | 3 |
| 1.3 | Background and Enrollment Metrics | 3 |
| 2.0 | SCOPE OF WORK | 5 |
| 2.1 | Operating Model and Governance | 5 |
| 2.2 | Operating and Integration Environment | 5 |
| 2.3 | Technology Solution Overview | 6 |
| 2.4 | Technology Design Principles | 7 |
| 2.5 | Service Center Scope and Responsibilities | 8 |
| 2.6 | EDE Management and Support | 9 |
| 3.0 | IMPLEMENTATION LIFECYCLE AND DELIVERABLES | 10 |
| 3.1 | Design, Development, and Implementation (DDI) | 10 |
| 3.2 | Technology Transition (TT) | 10 |
| 3.3 | Maintenance and Operations (M&O) | 11 |
| 3.4 | Governance Artifacts | 12 |
| 3.5 | Contract Deliverables (Post-Award Only) | 12 |
| 3.6 | Deliverables Framework and Deliverables Matrix | 12 |
| 3.7 | Stakeholder Coordination and Dependencies | 15 |
| 4.0 | KEY PERSONNEL COMMITMENT AND continuity | 16 |
| 5.0 | PROPOSAL PREPARATION AND SUBMISSION | 17 |
| 5.1 | Proposal Submission Structure | 17 |
| 5.2 | Pre-Award Submissions and Contract Deliverables | 18 |
| 5.3 | Submission Requirements Matrix | 19 |
Project Description The Oklahoma Insurance Department (OID), acting on behalf of the State of Oklahoma, will establish the Oklahoma Health Insurance Marketplace (the “Exchange”) as a State-Based Exchange (SBE) beginning with Plan Year (PY) 2028, in accordance with the Patient Protection and Affordable Care Act (ACA). Oklahoma’s approach leverages an EDE-first strategy that prioritizes distributed enrollment through Oklahoma Enrollment Partners (OKEPs), while maintaining a compliant State-Based Exchange consumer portal and capabilities consistent with applicable Federal requirements.
Under this model, consumer-facing functions, including eligibility application submissions, plan shopping, enrollment, and account management, may be delivered through a consumer portal and/or OKEPs. The Exchange will operate as a State-administered, governance-led marketplace, retaining responsibility for eligibility governance, enrollment oversight, integration management, regulatory compliance, and program integrity across a distributed partner ecosystem.
The Exchange intends to operate using an EDE-first approach in which OKEPs serve as the primary enrollment and consumer engagement channel. The Exchange may also maintain a compliant consumer portal integrated with the Exchange ecosystem to support direct consumer enrollments and required State-Based Exchange capabilities.
The Exchange does not intend to support or procure separate channel-specific platforms outside the Exchange ecosystem. This includes but is not limited to: (1) a separate standalone agent or broker portal, (2) a separate navigator portal, and (3) a dedicated standalone call center platform. Bidders shall not propose, include, or price distinct duplicate solutions or disconnected components for these capabilities.
Future-state architecture shall support long-term flexibility and modularity, including the potential for expanded EDE or EDE-only approaches should future Federal guidance and Notice of Benefit and Payment Parameters (NBPP) regulations permit broader implementation models.
This transition represents a shift from reliance on the Federally Facilitated Exchange (FFE) to a State-operated model that emphasizes flexibility, partner engagement, and long-term sustainability. The Exchange will support enrollment in Qualified Health Plans (QHPs) and Stand-Alone Dental Plans (SADPs) beginning with Open Enrollment 2027 for coverage effective January 1, 2028.
Scope of Procurement This procurement seeks a single, qualified Supplier to provide a comprehensive Exchange-enabling solution and associated services to support the State’s operation of an EDE-first State-Based Exchange.
The procured solution will serve as the foundation for core Exchange capabilities, including eligibility governance, enrollment oversight, integration management, and program integrity, within a distributed and partner-driven ecosystem. It will enable the State to deliver a seamless and compliant enrollment experience through a consumer portal and/or OKEPs while maintaining centralized control over critical program functions, data, and regulatory responsibilities.
The procurement includes the technology, integration capabilities, and operational services necessary to support year-round Exchange operations, including Open Enrollment Periods (OEP), Special Enrollment Periods (SEP), and other policy-driven events. The State intends to award a contract to a Supplier capable of delivering a secure, scalable, modular, and adaptable solution that supports the long-term evolution of the Exchange.
The anticipated contract term will begin in August 2026 and extend through July 2027, with up to four (4) optional annual renewals, subject to State approval.
Program Overview and Objectives The State of Oklahoma is transitioning from reliance on the Federally Facilitated Exchange (FFE) to a State-Administered, EDE-first Marketplace for Plan Year 2028. This transition is intended to provide the State with greater flexibility, control, and long-term sustainability in the administration of its health coverage programs.
The selected Supplier will play a critical role in enabling this transition and supporting ongoing Exchange operations. The State is seeking a comprehensive solution that supports high-quality enrollment experiences, strengthens program governance and oversight, and enables efficient and sustainable operations over time.
Key objectives of this initiative include:
· Establishing a State-operated, EDE-first Exchange that allows Oklahoma to retain user fee revenue and support long-term financial sustainability, including alignment with affordability initiatives such as the reinsurance program authorized under Oklahoma HB 1512 (2025).
· Delivering high-quality and efficient experience for consumers through OKEPs and/or consumer portal, while supporting the operational needs of issuers, partners, and Exchange staff.
· Strengthening State control over eligibility governance, health coverage policy, program integrity, compliance, and overall Exchange administration.
· Improving operational efficiency through enhanced data integration, reporting, and business intelligence capabilities.
· Achieving operational readiness by November 2027 to support Open Enrollment for Plan Year 2028.
· Ensuring alignment with all applicable Federal and State requirements, including ACA § 1311 (42 U.S.C. § 18031) and 45 C.F.R. Part 155.
· Supporting long-term operational and technical flexibility through modular architecture and enrollment channel strategies that may enable expended EDE operational approaches should future Federal guidance permit.
Background and Enrollment Metrics The following data provides context on Oklahoma’s Marketplace activity and enrollment patterns based on Plan Year 2026 Marketplace Open Enrollment Period (OEP) Public Use Files published by the Centers for Medicare & Medicaid Services (CMS). All metrics reflect activity as of the close of the OEP (January 15, 2026). These data points inform solution design, capacity planning, and operational readiness considerations for the Exchange.
Given the dynamic regulatory, policy, and market environment in which State-Based Exchanges operate, these metrics are subject to change over time due to factors such as policy updates, eligibility and enrollment trends, consumer behavior, and market conditions. As such, the data presented herein should be interpreted as a point-in-time baseline for planning purposes rather than a fixed projection of future activity.
Plan Year 2026 Applications for QHP Coverage
| Number of Submitted Applications |
| Individuals Applying for Coverage on Submitted Applications |
| Individuals Determined Eligible to Enroll in an Exchange Plan |
| Individuals Determined Eligible to Enroll, with Financial Assistance |
| Individuals Determined or Assessed Eligible for Medical Assistance/ CHIP by the Exchange |
| 219,383 |
| 300,270 |
| 283,722 |
| 255,727 |
| 19,977 |
Plan Year 2026 Plan Selections
| Total Number of Consumers Who Have Selected an Exchange Plan |
| New Consumers |
| Total Re-enrollees |
| Active Re-enrollees |
| Automatic Re-enrollees |
| 261,887 |
| 33,769 |
| 228,118 |
| 119,580 |
| 108,538 |
Plan Year 2026 Plan Selections Facilitated by an Agent / Broker (A/B)
| Total Consumers Enrolled Using an A/B |
| New Consumers Enrolled Using an A/B |
| Total Re-enrollees Using an A/B |
| Active Re-enrollees Using an A/B |
| Automatic Re-enrollees Using an A/B |
| 195,263 |
| 23,808 |
| 171,455 |
| 83,180 |
| 88,275 |
SCOPE OF WORK
The Scope of Work defines the responsibilities of the Supplier to design, implement, operate, and maintain a secure, scalable, and compliant EDE-first State-Based Exchange solution and associated services.
The Supplier will deliver a fully integrated solution and operational model supporting core Exchange functions, including eligibility processing, enrollment orchestration, case management, issuer coordination, communications, and regulatory reporting. This includes all activities required to support both implementation and ongoing operations, such as technology delivery, integration management, operational support services, and coordination with State and external partners.
The Exchange will operate as a governance-led, partner-integrated ecosystem in which consumer-facing functions are delivered through OKEPs and a consumer portal, with OKEPs serving as the primary enrollment channel. The Supplier will support this model by enabling centralized oversight of eligibility, enrollment, integration, and program integrity functions across the distributed environment, while ensuring reliable and secure data exchange with Federal, State, and commercial systems.
All detailed functional, technical, integration, security, performance, and operational requirements are defined in Exhibit 10 - Solution Requirements Matrix which governs in the event of any conflict. This SOW is structured to distinguish between capability expectations, detailed requirements, and delivery approach to support clear, consistent proposal responses.
Operating Model and Governance The Exchange will operate as a governance-led, partner-integrated ecosystem in which the State retains responsibility for eligibility governance, program integrity, regulatory compliance, and overall oversight of Exchange operations.
The Supplier will support this model by enabling coordinated operations across OKEPs, issuers, and Federal and State stakeholders. This includes supporting regulatory reporting, audit readiness, and ongoing compliance activities consistent with applicable Federal and State requirements.
The solution and associated services will be delivered in alignment with the State’s governance framework, supporting transparent operations, accountability, and effective coordination across all participating entities.
This section provides a high-level view of the operating environment. Detailed specifications are defined in the Exhibit 10- Solution Requirements Matrix and associated Exhibit 19 - Service Level Agreement (SLA).
Operating and Integration Environment The Exchange will operate within a connected ecosystem of Federal, State, and commercial partners that collectively support eligibility, enrollment, and ongoing Exchange operations.
The solution will integrate seamlessly within this multi-entity environment, enabling secure, real-time data exchange and coordinated processes across all participating systems. Within an EDE-first, the solution will support a multi-channel ecosystem in which OKEPs, a consumer portal, issuers, and other stakeholders support enrollment and consumer engagement, while the Exchange maintains centralized oversight of eligibility, enrollment, and program integrity functions.
The integration environment will support coordination with key external entities, including the Oklahoma Health Care Authority (OHCA), Centers for Medicare & Medicaid Services (CMS) systems such as the Federal Data Services Hub (FDSH), Qualified Health Plan issuers, System for Electronic Rates and Forms Filing (SERFF), OKEPs, and other Federal and commercial data sources that support eligibility and enrollment.
The solution will be designed using a modular, component-based architecture that enables independent deployment, enhancement, and replacement of system components without requiring full system downtime. This approach shall support the State’s ability to modify core functions, implement updates, or transition individual modules or services over time, thereby reinforcing State independence, reducing vendor lock-in, and minimizing technical debt.
The architecture shall support shared eligibility, enrollment, account management, workflow, and integration services across all authorized enrollment channels.
This approach enables a flexible and scalable operating model that can adapt to evolving policy, partner participation, enrollment channel strategies, and market dynamics while maintaining consistent, reliable, and secure operations across the ecosystem.
This section provides a high-level view of the operating and integration environment. Detailed specifications are defined in the Exhibit 10 - Solution Requirements Matrix and Exhibit 19 - Service Level Agreement (SLA).
Technology Solution Overview The future-state technology solution will support an EDE-first State-Based Exchange. The solution will provide a modern, scalable foundation that enables streamlined enrollment experiences through OKEPs and a consumer portal supporting the full lifecycle of Exchange operations, including eligibility support, enrollment orchestration, account management, issuer coordination, communications, and operational workflows.
The solution will support a modular and service-oriented architecture in which consumer enrollment capabilities are available through both OKEPs and a consumer portal, with OKEPs serving as the preferred and primary enrollment channel. The Exchange will maintain centralized oversight of eligibility, enrollment, compliance, and program integrity functions.
The solution shall support a unified and modular Exchange platform architecture in which enrollment channels leverage shared eligibility, verifications, enrollment, workflow, notice generation, and other integration services.
The State will retain ownership and control of the hosting environment and underlying infrastructure, including the cloud environment in which the solution operates, to ensure long-term flexibility, security, and portability. The Supplier will be responsible for managing, configuring, and operating the solution within this State-controlled environment, including all application-level services, integrations, and operational support required to meet performance, security, and availability expectations.
At its core, the solution will function as a connected ecosystem, enabling real-time coordination across Federal, State, and commercial systems that support eligibility determinations, enrollment processing, and issuer interactions. It will support a multi-partner environment that includes OKEPs, issuers, and other stakeholders, ensuring consistent data exchange, aligned processes, and a cohesive operational model across all participants.
The solution will be designed to reduce operational burden on the State by leveraging partner capabilities for consumer engagement and front-end interactions, while maintaining State control over critical program functions, data, and compliance. This approach supports flexibility in how the Exchange evolves over time, including the ability to onboard new partners, adapt to policy changes, modify enrollment channel strategies, and respond to market dynamics without significant system reconfiguration.
The architecture shall support future operational flexibility, including potential expansion toward broader EDE or EDE-only operational models should future Federal guidance permit.
The solution will deliver high performance, resilience, and scalability. It will support peak enrollment periods and sustain operational demand while maintaining a consistent, high-quality experience across the Exchange ecosystem.
The solution will also enable alignment with applicable federal requirements governing State-Based Exchanges, including the Affordable Care Act and implementing regulations at 45 C.F.R. Part 155, as defined by the Centers for Medicare & Medicaid Services (CMS). These capabilities will be embedded within the solution to support compliant eligibility determinations, enrollment processing, data exchange, privacy and security, reporting, and program integrity.
This section provides a high-level view of the future-state solution. Detailed specifications are defined in Exhibit 10 - Solution Requirements Matrix and Exhibit 19 - Service Level Agreement (SLA).
Technology Design Principles This section outlines the guiding principles that shape how the solution operates within the Exchange’s broader ecosystem. These principles are intended to promote interoperability, minimize disruption to existing processes, and support scalable, future-ready architecture.
The solution is expected to align with the following:
1. Medicaid Integration (OHCA):
The solution shall support inbound and outbound account transfers with the Oklahoma Health Care Authority using CMS aligned standards and protocols to support Medicaid assessments. Medicaid determinations are not in scope for this procurement, but the State may have interest in implementing this functionality in the future.
2. Federal Data Services Hub (FDSH):
The solution shall be capable of establishing a direct connection to the FDSH, while also maintaining flexibility to leverage an existing State connection if needed. It shall support the use of available federal income data sources for eligibility processing.
3. Issuer Integration:
The solution shall support integration with issuers using EDI approved standards, including the ingestion of plan data from SERFF, as well as provider files supplied by each issuer. The Supplier shall coordinate with issuers and provide a single point of contact to support interface implementation and ongoing operations.
4. Future Readiness:
The architecture shall support future expansion, including potential integration of eligibility and identity services, with minimal need for significant redesign or code changes.
Service Center Scope and Responsibilities The Supplier shall establish and support a Service Center capability aligned with the Exchange’s EDE-first operating model. The Service Center shall function as a Tier 2 support function. Tier 1 enrollment and consumer engagement activities are expected to primarily occur through OKEPs and/or a separate customer support center. The Supplier shall support Tier 3 activities by providing necessary data, analysis, and operational support but shall not perform functions reserved for State authority.
Tier Definitions
· Tier 1 – Consumer Support (OKEPs and/or Customer Support Center):
Frontline consumer interaction, including application submission, plan shopping, enrollment assistance, document upload, and initial issue identification.
· Tier 2 – Operational Support (Service Center):
Case management, document processing, issue resolution, escalation handling, and coordination across OKEPs, issuers, and systems.
· Tier 3 – Program Oversight (Vendor / Admin Exchange Staff):
Exception handling, regulatory interpretation, complex case adjudication, final decision-making authority, data corrections The Supplier shall provide the tools, workflows, and operational capabilities necessary to enable Exchange staff to perform Service Center functions.
The Supplier shall support integration and interoperability with customer support and operational technologies utilized by the Exchange, including State-operated and/or third-party platforms. The State has not finalized its future customer support and contact center technology stack and intends to collaborate with the successful Supplier to evaluate platform capabilities, integration approaches, and operational dependencies prior to determining any future customer support technology procurement decisions. The solution shall support integration with applicable technologies, which may include customer relationship management (CRM), telephony, case management, workforce management, chat, document management, and related customer support platforms necessary to support Exchange operations.
Service Center responsibilities include:
1. Outbound Communications and Notices The Supplier shall propose and implement a long-term solution for outbound consumer notices and communications, including notice generation, formatting, and distribution. The Supplier shall define an approach for mail development, printing, and distribution.
2. Document Processing (DMIs and SEPs) Consumers will submit documentation through OKEPs and/or a consumer portal.
The Supplier shall provide tools for Exchange staff to:
· Access submitted documentation
· Review, index, and process documents
· Associate documents to cases
· Support eligibility verification workflows
3. 1095-A Corrections and Appeals The Supplier shall support Exchange staff in managing 1095-A corrections and appeals processes, including case tracking, documentation review, and resolution workflows.
4. Case Management and Escalation The Supplier shall provide case management capabilities to support intake (via OKEPs), triage, escalation, and resolution across partners.
All Service Center capabilities must align with the Exchange’s EDE-first operating model and support centralized oversight. EDE Management and Support The Exchange will operate an EDE-first model in which OKEPs, including web brokers, agents, and other approved entities, serve as the primary consumer-facing channels.
The Supplier shall support this distributed ecosystem by establishing a structured approach to EDE partner integration, support, communication, and coordination. This includes providing technical integration support, defined escalation pathways, partner communication protocols, release coordination, and performance monitoring.
The Supplier shall ensure that EDE partners are supported through clearly defined processes, service levels, and access to environments and information necessary to effectively operate within the Exchange ecosystem.
Consumer Portal Capability The solution shall include a consumer-facing portal capability integrated with the Exchange ecosystem and shared Exchange services. The architecture shall support the flexibility for the Exchange to implement and operate a consumer portal with an option to implement an EDE-only approach should future Federal guidance permit.
The consumer portal shall support compliant State-Based Exchange consumer-facing capabilities, including consumer account management, application submission, eligibility workflows, plan shopping, enrollment support, notices, document upload, and related consumer service capabilities required to support Exchange operations and regulatory compliance.
The consumer portal shall leverage shared eligibility, enrollment, workflow, notice generation, account management, and integration services utilized across the Exchange ecosystem.
The Supplier shall include all pricing associated with a consumer portal capability within the base proposal and Exchange solution pricing structure.
OMES Standards, Policies, and Architecture Compliance The Supplier shall comply with all applicable State and Federal security, privacy, technology, and data protection requirements, including policies, standards, procedures, and guidance issued by the Oklahoma Office of Management and Enterprise Services (OMES).
The Supplier shall review and comply with applicable OMES policies, standards, security requirements, and enterprise architecture guidance, including the following resources:
· OMES Information Services Policies and Standards https://oklahoma.gov/omes/divisions/information-services/about-information-services/policy-and-standards.html
· Oklahoma Data Security Standards https://oklahoma.gov/content/dam/ok/en/omes/documents/data-security-standard.pdf
· OMES Enterprise Reference Architecture https://oklahoma.gov/content/dam/ok/en/omes/documents/enterprise-reference-architecture.pdf
The Supplier shall be responsible for ensuring that its proposed solution architecture, hosting approach, staffing model, operational processes, subcontractors, and support model comply with applicable State standards, security requirements, architecture guidance, and environment access restrictions.
Failure to account for applicable State requirements and restrictions shall not relieve the Supplier of its contractual obligations, delivery responsibilities, operational commitments, or project schedule requirements.
IMPLEMENTATION LIFECYCLE AND DELIVERABLES
The implementation lifecycle translates the Exchange’s operating model into a structured delivery approach that enables the successful design, deployment, and operation of the solution.
This lifecycle is designed to support a governance-led, partner-integrated ecosystem, ensuring alignment with the State’s approach to eligibility oversight, enrollment coordination, and distributed service delivery through OKEPs.
The Supplier will execute all activities required to deliver and operate the solution in alignment with this operating model, ensuring readiness for Open Enrollment 2027 and sustained operational success.
The lifecycle is organized into three phases:
· Phase 1: Design, Development, and Implementation (DDI)
· Phase 2: Technology Transition (TT)
· Phase 3: Maintenance and Operations (M&O)
The Supplier will maintain an Integrated Project Schedule (IPS) and Integrated Implementation Plan (IIP) throughout the lifecycle. These artifacts will define sequencing, dependencies, milestones, and coordination across the Exchange and external stakeholders and will serve as the foundation for delivery oversight and governance.
Design, Development, and Implementation (DDI) The DDI phase, which is aligned to the Design, Development, and Implementation (DDI Stages 1-5) as defined in the IPS Instruction document, establishes the foundation for the solution and prepares it for transition to production operations.
During this phase, the Supplier will collaborate with the Exchange and stakeholders to validate and iteratively refine requirements, workflows, configurations, integrations, and solution designs to support the Exchange’s EDE-first operating model. Activities include solution configuration, integration planning, environment setup, stakeholder review and validation activities, and development of strategies for testing, data migration, training, operational readiness, and enrollment channel coordination.
The Supplier shall support an iterative and collaborative design approach that includes ongoing stakeholder engagement, requirements refinement, configuration validation, prototype and workflow reviews, integration coordination, and operational feedback cycles throughout the project lifecycle. The Supplier shall maintain appropriate documentation, requirements traceability, version control, and change management processes necessary to ensure that approved refinements are incorporated into project deliverables, configurations, testing activities, and implementation planning. Iterative refinement activities performed in accordance with the Scope of Work and approved project governance processes shall not independently constitute grounds for additional compensation unless such activities result in a formally approved material change in scope.
The DDI phase results in a fully configured and integrated solution prepared for formal testing, certification, and transition activities. This phase establishes the foundation for the solution to operate within the Exchange’s multi-partner ecosystem and supports the integration, governance, and operational capabilities defined in Section 2.
Technology Transition (TT) The Technology Transition phase focuses on validating the solution and preparing the Exchange for production operations.
During this phase, the Supplier will execute all required testing activities, including system, integration, performance, and security testing, and will support User Acceptance Testing (UAT) and defect resolution. The Supplier will complete data migration activities, support required Federal certification processes, and coordinate readiness across all integration partners, including OKEPs, issuers, and State and Federal systems.
The Supplier shall be responsible for supporting onboarding, integration coordination, connectivity validation, testing support, and operational readiness activities necessary to enable approved OKEPs and other authorized external partners to successfully utilize the Exchange ecosystem.
This phase includes training delivery, cutover planning, and production deployment, along with post-go-live stabilization support to ensure system performance and operational continuity.
The TT phase ensures that the solution performs as intended within the Exchange’s operating environment and is fully prepared to support real-time interactions across the partner ecosystem. It culminates in full operational readiness for Open Enrollment and successful transition to steady-state operations.
Maintenance and Operations (M&O) The Maintenance and Operations phase represents the ongoing execution of the Exchange’s operating model, in which the solution supports continuous eligibility, enrollment, and integration activities across the partner ecosystem.
During this phase, the Supplier will operate and maintain all components of the solution required to support Exchange functionality. This includes ongoing support for eligibility processing, enrollment orchestration, and integration services; incident, problem, and change management; and coordination with the State and external stakeholders. This will also include service center operational support as defined above.
The Supplier will support Open Enrollment and Special Enrollment Period operations, maintain system performance and availability, and ensure continued alignment with applicable Federal and State requirements.
The Supplier will establish and support a formal governance structure for managing system changes and enhancements, including a Change Control Board (CCB) in coordination with the State. The CCB shall provide oversight of change intake, prioritization, impact assessment, and approval of system updates across the solution lifecycle.
The M&O phase also includes continuous improvement, system enhancements, and ongoing operational support to sustain and evolve the Exchange over time. The Supplier shall implement a structured release management approach that includes routine maintenance updates, defect resolution, patches, and hotfixes, with defined processes for testing, approval, deployment, and rollback. Emergency changes shall be supported through expedited procedures that maintain system stability and security.
The Supplier will proactively monitor system performance, identify opportunities for optimization, and recommend enhancements to improve functionality, usability, and operational efficiency, while minimizing disruption to Exchange operations.
Governance Artifacts The Supplier will develop and maintain key governance artifacts to support planning, execution, and oversight across all phases of the lifecycle.
These artifacts include, at a minimum:
· Integrated Project Schedule (IPS)
· Integrated Implementation Plan (IIP)
· Requirements Traceability Matrix (RTM)
· System Security Plan (SSP) and Plan of Action and Milestones (POA&M)
· Testing Strategy and Execution Plan
· Change and Release Management Plan
· Risk and Issue Management Plan
· EDE Management Plan
These artifacts will be established during the DDI phase and maintained as living documents throughout the contract term. All artifacts are subject to State review, approval, and ongoing governance.
Contract Deliverables (Post-Award Only) Delivery governance ensures that all implementation and operational activities remain aligned with the Exchange’s operating model and that the solution continues to meet performance, compliance, and operational expectations defined in Section 2.
The Supplier will ensure that all deliverables align with the Integrated Project Schedule and that dependencies with the State and external stakeholders are actively managed. All deliverables are subject to formal review, validation, and written approval by the State.
A deliverable will be considered complete when it:
· Meets applicable requirements defined in the Requirements Matrix
· Successfully completes required testing and validation activities
· Addresses all critical defects, unless otherwise accepted by the State
· Receives formal written approval from the State
All deliverables and supporting artifacts must remain audit-ready and support compliance with applicable Federal and State oversight requirements.
Progression between lifecycle phases requires formal State approval based on demonstrated readiness and successful completion of required activities.
Deliverables Framework and Deliverables Matrix The Supplier will produce and maintain deliverables aligned to each phase of the implementation lifecycle to support solution design, implementation, validation, transition, and ongoing operations.
The Deliverables Matrix defines required deliverables, associated lifecycle phases, and alignment to key activities. These deliverables support governance, traceability, operational readiness, and ongoing Exchange operations.
All deliverables are subject to the delivery governance and acceptance framework defined in Section 3.5 and must align with the Integrated Project Schedule.
| Deliverable |
| Description |
| Phase |
| Project Management Plan |
| Governance, controls, roles, decision authority, and management approach for delivery, including communication, reporting, and escalation processes |
| DDI, TT, M&O |
| Integrated Project Schedule (IPS) |
| Comprehensive project schedule including milestones, dependencies, resource allocation, and coordination across all stakeholders |
| DDI, TT, M&O |
| Integrated Implementation Plan (IIP) |
| Execution strategy for designing, configuring, integrating, testing, and deploying the solution |
| DDI, TT, M&O |
| Risk and Issue Management Plan |
| Framework for identifying, tracking, managing, and resolving risks and issues |
| DDI, M&O |
| Change and Release Management Plan |
| Governance and processes for managing system changes, releases, and enhancements |
| DDI, M&O |
| Functional Specifications Package |
| Future-state workflows, validated requirements, and configuration specifications supporting the solution |
| DDI |
| Requirements Traceability Matrix (RTM) |
| End-to-end mapping of requirements to design, configuration, testing, and operations |
| DDI, TT, M&O |
| Data Management Plan |
| Approach for data governance, quality, lifecycle management, standards, validation, and data stewardship |
| DDI, M&O |
| Solution Roadmap |
| Forward-looking plan for system enhancements, capability expansion, and alignment with policy and operational changes |
| DDI, M&O |
| Integration Plan |
| Strategy and sequencing for integrating with CMS, OKEPs, issuers, OHCA, and other external systems, including onboarding and dependency management |
| DDI, TT |
| EDE Management Plan |
| Operational, integration, and governance framework for managing the EDE ecosystem, including roles, workflows, and escalation across partners |
| DDI, M&O |
| EDE API Companion Guide |
| Documentation of EDE interfaces, workflows, and integration behaviors |
| DDI, M&O |
| EDI Companion Guide |
| Documentation of EDI transactions, formats, and integration standards (e.g., enrollment transactions) |
| DDI, M&O |
| Data Conversion and Migration Plan |
| Approach for data extraction, transformation, validation, reconciliation, migration sequencing, and rollback procedures |
| DDI, TT |
| System Security Plan (SSP) |
| Security architecture, controls, compliance documentation, and remediation tracking aligned with State and Federal requirements |
| DDI, M&O |
| Security Certification Artifacts |
| Documentation supporting CMS ATC and other required Federal and State certifications |
| DDI, TT, M&O |
| Testing Strategy and Test Plan |
| Governance and approach for all testing activities, including system, integration, performance, and user acceptance testing |
| DDI, TT |
| Defect Management Plan |
| Processes for defect identification, tracking, prioritization, and resolution |
| DDI, M&O |
| Integration Test Results Package |
| Results and validation of integration testing across all external systems and partners |
| DDI, TT |
| Performance and Scalability Validation Report |
| Evidence of system performance under expected and peak conditions, including Open Enrollment |
| TT |
| Operational Readiness Assessment |
| Validation of system, integration, and operational readiness for production deployment |
| TT |
| Cutover and Transition Plan |
| Plan for production deployment, cutover activities, and transition to operations |
| TT |
| Implementation Closeout Report |
| Summary of implementation outcomes, deliverable completion, defect status, and readiness for transition to Maintenance and Operations |
| TT |
| Maintenance and Operations Plan |
| Ongoing operational procedures, support model, and coordination across stakeholders |
| M&O |
| Service Center Operations Plan |
| Tier 2 operational model including staffing, case management workflows, document processing, escalation, and coordination with OKEPs and issuers |
| TT, M&O |
| Mail Operations Solution |
| Approach for notice generation, formatting, printing, and distribution of outbound communications |
| TT, M&O |
| Disaster Recovery and Business Continuity Plan |
| Approach for system recovery, failover, continuity of operations, and annual testing, including defined recovery objectives |
| DDI, M&O |
| Training Plan and Materials |
| Role-based training approach, materials, and knowledge transfer artifacts to support system use and operations |
| DDI, TT |
| User Reference Manual |
| Comprehensive documentation of system functionality and business processes for end users and administrators |
| TT, M&O |
| EDE Support, Escalations, SLAs, and Communications Plan |
| End-to-end approach for supporting OKEPs |
| DDI, M&O |
| FFM Divergence Plan |
| Deviations from CMS FFM standards and defines how such divergences will be managed, communicated, and supported for OKEPs |
| DDI, M&O |
| EDE Release and Communication Approach |
| Communication of system changes, releases, and updates to OKEPs |
| DDI, M&O |
| UAT Environment Access and Coordination Approach |
| Plan for OKEPs to access and utilize shared UAT environments |
| DDI, M&O |
Stakeholder Coordination and Dependencies The Supplier will coordinate with all stakeholders participating in the Exchange ecosystem to support the integrated operating model described in Section 2.
This includes coordination with Federal agencies, State partners, issuers, and OKEPs to ensure alignment across all aspects of solution delivery and operations.
All external communications to key stakeholders shall be coordinated with the State, with the State retaining approval authority for formal communications and receiving visibility into ongoing stakeholder correspondence, as defined by the State.
The Supplier will identify, manage, and communicate all dependencies requiring stakeholder participation and ensure that coordination activities are incorporated into the Integrated Project Schedule.
Deliverables that depend on external stakeholder input or validation will not be considered complete until appropriate coordination has occurred and required inputs have been incorporated.
Warranty Period Following successful production implementation and State approval of go-live, the Supplier shall provide a warranty period of no less than ninety (90) calendar days.
During the warranty period, the Supplier shall, at no additional cost to the State:
· Correct defects, configuration issues, integration failures, processing errors, and other issues associated with the implemented solution;
· Provide remediation support for issues identified in production operations;
· Support stabilization activities necessary to achieve operational readiness and production stability;
· Resolve defects or operational issues associated with interfaces, integrations, workflows, notices, eligibility processing, enrollment processing, and other implemented functionality;
· Support connectivity, onboarding, integration validation, and operational issue resolution necessary to ensure that State-approved Oklahoma Enrollment Partners (OKEPs), issuers, and other authorized external entities are able to successfully connect to, interact with, and utilize the solution and associated integration services;
· Support remediation of issues impacting Open Enrollment, Special Enrollment Periods, account transfers, eligibility transactions, enrollment transactions, and other Exchange operational functions.
The warranty period shall not relieve the Supplier of responsibility for defects, deficiencies, noncompliance, security vulnerabilities, or failures resulting from Supplier-provided deliverables, configurations, customizations, integrations, or services identified after the conclusion of the warranty period.
The State reserves the right to extend the warranty period for unresolved Severity 1 or Severity 2 defects, failed deliverables, unsuccessful integrations, or material operational deficiencies that remain open at the conclusion of the warranty period.
KEY PERSONNEL COMMITMENT AND continuity Key Personnel are considered critical to successful delivery of the Scope of Work and will be a material factor in proposal evaluation and contract performance. All Key Personnel identified in the Supplier’s proposal are expected to be assigned to the project upon contract award and remain actively engaged throughout the applicable phases of the implementation lifecycle and ongoing operations.
At a minimum, Key Personnel will include:
· Program and/or Project Manager
· Technical and Security Leads
· Fraud, Waste, and Abuse Lead and/or EDE Lead
· Implementation Leads
· Operations Leads
The Supplier will ensure continuity and stability of Key Personnel to support consistent delivery and operational performance. Key Personnel may not be removed, reassigned, or replaced without prior written approval from the State.
In the event that a personnel change is approved, the Supplier will provide a qualified replacement with equal or greater experience and ensure a structured transition that includes knowledge transfer and continuity of responsibilities. Unless otherwise approved by the State, a minimum transition period of ten (10) business days will be provided.
The Supplier will maintain documented transition plans for all Key Personnel roles and ensure that any personnel changes do not negatively impact project delivery, operational stability, or service quality.
PROPOSAL PREPARATION AND SUBMISSION
Bidders shall submit proposals that clearly demonstrate their ability to deliver the Scope of Work described in Section 3 and align with the operating model and solution approach defined in Section 2.
The Cost Proposal must reflect the Exchange’s EDE-first and shall include all costs necessary to support a consumer portal, shared Exchange services, integrations, and ongoing Exchange operations.
Proposals must be complete, clearly organized, and structured in accordance with the requirements outlined in this section to support consistent evaluation.
In the event of any inconsistency:
· The Requirements Matrix governs all functional, technical, and operational requirements
· The RFP governs over any bidder narrative unless explicitly accepted by the State
Failure to provide all required components may result in the proposal being deemed non-responsive.
Proposal responses will be evaluated in accordance with the evaluation criteria and scoring methodology defined in Exhibit 07 – Evaluation and Scoring Criteria using Exhibit – Individual Evaluator Scoring Form. Bidders should ensure that all submission components clearly address the evaluation factors identified in the associated Attachment and Exhibit.
Proposal Submission Structure Bidders shall organize their proposal in accordance with the Submission Requirements Matrix.
Proposals shall be structured across the following four (4) components:
1. Administrative and General Information This component includes all required forms, certifications, and general information necessary to establish bidder eligibility and compliance with State requirements.
These materials are primarily used to verify completeness, responsiveness, and compliance with procurement standards. While most items in this category are not scored, failure to provide required documentation may result in the proposal being deemed non-responsive.
2. Mandatory Supplier Qualifications This component includes responses to mandatory qualification requirements that establish the Bidder’s minimum capability to perform the Scope of Work.
Responses in this category are evaluated on a pass/fail basis. Bidders must demonstrate that all mandatory qualifications are met in order to be considered for further evaluation.
A standardized template will be provided for this component. Bidders shall complete this template in its entirety and adhere to all instructions and formatting requirements.
3. Technical and Operational Narrative This component represents the core of the Bidder’s proposal and must clearly demonstrate the ability to deliver the solution and operate within the Exchange’s governance-led, partner-integrated, EDE-first model.
Responses shall address the Bidder’s:
· Technical solution and architecture
· Delivery and implementation approach
· Operations and maintenance model
· Security, compliance, and program integrity capabilities
· Staffing model and organizational approach
· Business model flexibility and transition strategy
This component is fully scored and should provide sufficient detail, supporting artifacts, and examples to demonstrate the Bidder’s experience, approach, and ability to meet the State’s objectives.
Each narrative submission component will be further defined within the associated Attachments/Exhibits referenced in the Submission Requirements Matrix. The Attachments and Exhibits will include instructions, required sections, and specific response expectations.
Standardized templates will be provided. Bidders shall complete each template as provided and adhere to the defined structure, content requirements, and formatting instructions.
4. Cost Proposal This component includes all pricing associated with delivery of the Scope of Work and ongoing operations. The Cost Proposal must align with the implementation lifecycle defined in Section 3 and include all costs associated with implementation, transition, and Maintenance and Operations.
This component is scored separately and will be evaluated for completeness, reasonableness, and alignment with the proposed technical and operational approach.
The State reserves the right to reject or not evaluate responses that deviate from the required templates.
Pre-Award Submissions and Contract Deliverables All submissions required under this section represent pre-award artifacts provided for evaluation purposes and will be considered binding representations of the Bidder’s proposed approach.
These submissions do not constitute final Contract deliverables. Upon award, the selected Supplier will be required to refine and finalize all proposed artifacts into State-approved baseline deliverables in accordance with Section 3.
In the event of any conflict between proposal submissions and Contract requirements, the Contract and State-approved deliverables will govern.
Bidders should structure their responses to ensure clear alignment between submission components and the corresponding evaluation factors.
Submission Requirements Matrix
| Component |
| Required Exhibits or Form |
| Evaluation Type |
| Administrative and General Information |
| Cover Page |
| N/A |
| Administrative and General Information |
| Exhibit 01 - Executive Summary Worksheet |
| Scored |
| Administrative and General Information |
| From CP076 - Responding Bidder Information |
| N/A |
| Administrative and General Information |
| Signed Amendments to Solicitation (if any) |
| Administrative and General Information |
| Disclosures (reference section 7.3.4) |
| N/A |
| Administrative and General Information |
| Certification for Competitive Bid and/or Contract (Non-Collusion Form CP004). |
| N/A |
| Administrative and General Information |
| Bidder’s Certificate of Insurance (reference section 7.3.5) |
| N/A |
| Administrative and General Information |
| Authority to Operate (ATO) or confirmation that an ATO has been requested |
| N/A |
| Administrative and General Information |
| Up to the last three years of audited financial statements and up to three years of tax returns |
| N/A |
| Administrative and General Information |
| Third-Party Supplier Information |
| N/A |
| Administrative and General Information |
| OMES IT Security Certification |
| N/A |
| Administrative and General Information |
| Three (3) Exhibit 05 – Reference Forms |
| Scored |
| Mandatory Supplier Qualifications |
| Exhibit 08 – Mandatory Qualifications Response |
| Pass / Fail |
| Mandatory Supplier Qualifications |
| Exhibit 10 – Solution Requirements Matrix |
| Scored |
| Technical and Operational Narrative |
| Exhibit 11 - EDE Marketplace Qualifications |
| Scored |
| Technical and Operational Narrative |
| Exhibit 13 - Technical Solution and EDE Architecture |
| Scored |
| Technical and Operational Narrative |
| Exhibit 12 - Integrated Delivery and Implementation Approach |
| Scored |
| Technical and Operational Narrative |
| Exhibit 14 - Exchange Operations and Ecosystem Management Approach |
| Scored |
| Technical and Operational Narrative |
| Exhibit 16 - Program Integrity, Security, Privacy, and Compliance |
| Scored |
| Technical and Operational Narrative |
| Exhibit 15 - Business Model Flexibility and Transition Strategy |
| Scored |
| Technical and Operational Narrative |
| Exhibit 17 - Staffing Model and Key Personnel |
| Scored |
| Technical and Operational Narrative |
| Exhibit 12 - Integrated Project Schedule |
| Scored |
| Cost Proposal |
| Exhibit 02 - Cost Proposal |
| Scored |
Components identified as “Pass/Fail” or “Scored” will be evaluated in accordance with the detailed criteria and weighting defined in Exhibit 07 – Evaluation and Scoring Criteria. The State may limit evaluation to the information provided within the required templates and submission components defined in this section.
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