Exhibit_7_-_Evaluation_and_Scoring_Criteria.docx

Exhibit 7 – Evaluation Criteria and Scoring Framework

Evaluation and scoring methodology The State of Oklahoma will evaluate all proposals in accordance with the evaluation criteria and procedures described in this Section. The purpose of this methodology is to ensure an objective, transparent, and consistent evaluation process that results in the selection of the Proposal that provides the best value to The State of Oklahoma.

Evaluation Overview Proposals will be evaluated by an Evaluation Committee comprised of State staff and subject matter experts.

Evaluations will be conducted solely on:

· Submitted Proposal materials as defined in the Proposed Submission Structure and Submission Requirements Matrix

· Responses provided within required templates and submission components

· Clarifications requested by the State, if applicable

· Oral presentations or demonstrations, if requested

A Proposal must be determined to be both responsive and submitted by a responsible Bidder to be considered for award. A responsive Proposal is one that conforms in all material respect to the requirements of this RFP. A responsible Bidder is one that demonstrates the capability, integrity, and reliability to perform the requirements of the Contract.

All members of the Evaluation Committee will be required to disclose any actual or potential conflicts of interest prior to participating in the evaluation process. Any evaluator with a conflict of interest may be removed or recused from participation at The State of Oklahoma’s discretion. Evaluators will be required to maintain the confidentiality of all Proposals and evaluation materials and may not disclose or discuss such information outside of the official evaluation process.

Bidders must disclose any actual, potential, or perceived conflicts of interest in their proposal. The State of Oklahoma will evaluate disclosed conflicts to determine whether a conflict exists and whether it can be mitigated. The State of Oklahoma reserves the right, in its sole discretion, to determine that a conflict of interest renders a Bidder ineligible for award or to require appropriate mitigation measures as a condition of continued participation.

Best Value Determination Award will be given to the responsive and responsible Bidder, whose proposal is determined to provide the best value to the State of Oklahoma.

Best value will be determined based on the combined evaluation of technical and cost factors as described herein.

The State of Oklahoma is not obligated to select the Proposal with the lowest cost.

Evaluation Basis and Submission Dependency Evaluation will be conducted exclusively on the Bidder’s submitted Proposal materials as defined in the Proposed Submission Structure and Submission Requirements Matrix.

Section 3 deliverables represent post-award contractual obligations only and will not be scored as completed deliverables. Instead, evaluation will assess the feasibility, completeness, and credibility of the Bidder’s proposed approach to delivering those outcomes.

evaluation approach Proposals will be evaluated using a structured, multi-stage evaluation process. Advancement to subsequent stages will be based on results of the preceding stage.

The State of Oklahoma reserves the right to determine which Bidders advance at each stage.

The evaluation process consists of four stages:

· Stage 1: Administrative Review

· Stage 2: Technical and Business Proposal Evaluation

· Stage 3: Oral Presentations, Reference Checks, and Best and Final Offers (BAFO) (if applicable)

· Stage 4: Apparent Successful Bidder Selection and Contract Negotiation

Stage 1: Administrative Review The State of Oklahoma will conduct an initial compliance review to confirm that Proposals:

· Include all required forms and documentation

· Meet Minimum Mandatory Qualifications

· Are responsive to RFP requirements

Responses that are incomplete, unsigned, or fail to meet mandatory requirements may be rejected without further evaluation, unless the State of Oklahoma elects to waive such issues as minor administrative irregularities. The State of Oklahoma may request clarification from Bidders during this stage.

Only responsive and qualified Bidders will advance to Stage 2. The State of Oklahoma’s determination of a Bidder’s responsibility is not limited to a single stage of the evaluation process. The State of Oklahoma reserves the right to evaluate and re-evaluate a Bidder’s qualifications, financial condition, past performance, and ability to successfully perform the Contract at any time prior to award.

Minimum Mandatory Qualifications Review

The State of Oklahoma will evaluate whether each Bidder meets the Minimum Mandatory Qualifications specified below. Only Bidders meeting all such qualifications will advance.

The apparent successful / selected Bidder must meet the minimum qualifications listed below:

Marketplace / Government Program Experience (End-to-End Delivery)

Bidder must demonstrate experience delivering full lifecycle implementation and operations of large-scale public sector or health insurance marketplace systems, including design, configuration, testing, deployment, transition to operations, and ongoing M&O for programs supporting at least 100,000 enrollees, across at least two states.

P/F

Key Personnel with Marketplace Expertise

The Bidder shall propose and maintain key personnel with proven experience in state-based marketplace programs and/or operationalizing a transition to a state-based exchange. Key personnel must demonstrate experience in one or more of the following areas, or a combination thereof:

· Federal and state regulatory requirements

· Eligibility and enrollment processes

· Plan management

· Related compliance obligations

· Standing up business operations, establishing governance, defining operational models, readiness planning, training, cutover/go-live support, and post-go-live stabilization

The Bidder must provide résumés or equivalent documentation for each proposed key staff member showing relevant experience. The requirement will be considered satisfied only if all proposed key personnel clearly demonstrate experience in at least one area, supported by verifiable evidence such as prior project roles or deliverables.

P/F

Eligibility, Enrollment, and ACA Regulatory Experience

Bidder must demonstrate experience designing and operating eligibility determination and enrollment systems within ACA or comparable regulated environments, including reconciliation, data migration, issuer coordination, and post-enrollment account maintenance processes.

The Bidder must provide examples from at least two projects that involved deep integration with a specific state’s Medicaid and eligibility systems. Examples must include performance metrics demonstrating successful delivery of eligibility and enrollment functions.

P/F

Cloud, Architecture, and Platform Delivery

Bidder must demonstrate experience delivering and operating secure, scalable platforms within client-owned and governed cloud environments. The State will own and govern the cloud environment, and the Supplier will manage, provision, configure, deploy, and operate the solution within this environment in alignment with the enterprise architecture, security, and technology standards established by the Oklahoma Office of Management and Enterprise Services (OMES).

Experience must include operating within externally governed environments, aligning to enterprise standards for identity and access management, data governance, and network security, and supporting multi-environment architectures (sandbox, test, training, UAT, and production) with high availability, scalability, and both real-time and batch processing.

P/F

Enterprise Data Integration

Bidder must demonstrate experience integrating with external government and issuer systems, including CMS Federal Data Services Hub (FDSH), Medicaid systems, and EDI 834 standards supporting secure real-time and batch data exchange with full encryption, secure authentication, and compliant data handling.

P/F

Security, Privacy, and Program Integrity

Bidder must demonstrate experience in compliance with federal and state security and privacy standards for IRS 1075, CMS frameworks for MARS-E/ARC-AMPE, SOC 2, this includes secure authentication (e.g., mutual TLS/three-way handshake), encryption in transit and at rest, continuous monitoring, audit logging, fraud, waste, and abuse detection and prevention capabilities.

P/F

Stage 2: Technical and Business Proposal Evaluation Proposals that pass Stage 1 will be evaluated in Stage 2. The State of Oklahoma will evaluate Technical and Business Proposals to identify those that best align with the State’s objectives and provide the greatest overall value.

Each evaluator will independently score Proposals using a standardized scoring scale. Scores will be averaged to determine final scores.

Scoring Methodology Proposals will be scored using a standardized scale:

· 5 – Significantly Exceeds Requirements

· 4 – Exceeds Requirements

· 3 – Meets Requirements

· 2 – Partially Meets Requirements

· 1 – Does Not Meet Requirements

Scores will be weighted and combined to produce a final total score for each Proposal.

Stage 2: Technical and Business Proposal Evaluation Scoring Criteria

Higher scores will be awarded for demonstrated capability in end-to-end delivery of large-scale, complex eligibility and enrollment systems in regulated, multi-stakeholder environments, showing strength in integrating technology, operations, and stakeholder coordination in environments comparable in scale and complexity.

Consideration will be given to experience operating in ACA/CMS-aligned or similarly regulated environments, and delivering complex multi-stakeholder ecosystems involving government agencies, issuers, and external enrollment partners.

Executive Summary

Exhibit 11 –Marketplace Qualifications

Three (3) Exhibit 05 - References

Higher scores will be awarded to structured governance models, disciplined project management practices, and strong risk, issue, and dependency management.

The evaluation will consider Bidder’s approach to testing and release management, including functional, integration, performance, and operational validation, as well as the ability to manage phased deployments and ensure a controlled and effective transition into steady-state operations.

Exhibit 18 - Integrated Project Schedule

Exhibit 12 - Integrated Delivery and Implementation Approach

The evaluation will also consider the ability to support a unified Exchange ecosystem that enables enrollment and consumer engagement through both Oklahoma Enrollment Partners (OKEPs) and the State-operated consumer portal utilizing shared eligibility, enrollment, workflow, and integration services.

Higher scores will be awarded for modular, maintainable, and extensible system designs that support deployment on state-controlled cloud environments. Proposals that demonstrate full State ownership and control of custom-developed code, configurations, and system deliverables, including the ability to modify, transfer, or transition the system to another Bidder or internal operations without restriction, will be rated more favorably. Solutions that minimize reliance on proprietary tools, restrictive licensing, or Bidder-controlled environments and provide transparent access to system components, documentation, and configurations will also receive higher scores.

The evaluation will consider integration architecture and interoperability, including API-first design supporting real-time and batch data exchange with federal, state, and third-party systems such as CMS, FDSH, Medicaid, issuers, and enrollment partners. Consideration will also be given to OKEPs integration models, onboarding and certification support, and cross-system workflow orchestration, including reconciliation and exception handling.

Additional consideration may be given to solutions that support long-term operational flexibility, including the ability to adapt enrollment channel strategies or support expanded EDE operational approaches should future Federal guidance permit.

Bidder approaches to lock-in mitigation will be evaluated, including modular system design, clear transition and exit strategies, and the ability to migrate or replace system components over time. The State of Oklahoma expects Bidders to describe how enrollment and eligibility data, including all associated records and supporting datasets, can be ported, migrated, or otherwise made accessible across environments in alignment with the State’s multi-cloud strategy. Responses should address data portability, interoperability, and the ability to support transition, replication, or migration of data across cloud environments without undue dependency on proprietary tools, formats, or Bidder-controlled infrastructure. Approaches that demonstrate flexibility, transparency, and alignment with State control objectives will be evaluated more favorably.

Performance, reliability, and operational stability under real-world load conditions are key evaluation factors. This area will be heavily weighted within this scoring category.

Exhibit 13 - Technical Solution and Architecture

Exhibit 15 - Business Model Flexibility and Transition Strategy

Exhibit 10 – Solution Requirements Matrix

Higher scores will be awarded for demonstrated capability to support eligibility and enrollment operations, plan management, and marketplace services delivered through distributed enrollment models such as OKEPs while enabling enrollment capabilities though a consumer-facing portal.

The evaluation will consider issuer integration and coordination, including plan data exchange, reconciliation processes, and lifecycle data integrity management. It will also assess the Bidder’s ability to support enrollment partners through onboarding, certification, troubleshooting, and ongoing operational enablement.

Additional consideration will be given to back-office operational capabilities, including case resolution, administrative processing, and workflow support necessary to maintain efficient and effective marketplace operations.

Exhibit 14 - Exchange Operations and Ecosystem Management Approach

Exhibit 18 - Integrated Project Schedule

Higher scores will be awarded for integrated fraud, waste, and abuse (FWA) prevention capabilities, program integrity dashboards with drill-down and investigative views to identify top concentration drivers (e.g., by broker or agency), risk-based scoring, and cybersecurity controls such as identity and access management, encryption, audit logging, and continuous monitoring.

The evaluation will also consider privacy protections for sensitive data (including PII/FTI), alignment with applicable regulatory frameworks (including CMS-aligned and IRS requirements), and the ability to support audit readiness, transparency, and regulatory reporting. Strong solutions will demonstrate real-time anomaly detection, risk-based monitoring, and incident response capabilities embedded within operational workflows.

Exhibit 16 - Program Integrity, Security, Privacy, and Compliance

Proposals must include a clearly defined staffing approach that minimizes required effort and cost to the Exchange, including the use of managed services where appropriate. Bidders shall identify key personnel, their roles, and level of commitment to the project, with strong consideration given to approaches that include dedicated resources for key business functions.

The evaluation will consider the extent to which the staffing model integrates program, policy, technical, and operational expertise, supported by defined governance structures, roles and responsibilities, and escalation paths.

Proposals should demonstrate the ability to scale staffing across project phases and provide verifiable evidence of recent, relevant experience supporting state-based marketplace policy implementation or full lifecycle SBE transitions.

Additional consideration will be given to approaches that embed program and policy expertise into staffing strategies, including recruitment, retention, collaboration, and subcontractor management, ensuring alignment across technical, operational, and policy objectives.

The qualifications and relevant experience of key personnel in delivering and operating complex government healthcare or eligibility systems will also be evaluated, along with the strength of proposed knowledge transfer and succession planning strategies.

Exhibit 17 - Staffing Model and Key Personnel

Cost Evaluation and Price Realism Cost Proposals will be evaluated using a normalized scoring methodology, in conjunction with an assessment of cost realism and alignment with the Proposal.

The lowest cost proposal will receive the maximum available points. Other proposals will be scored proportionally. In addition to mathematical scoring, The State of Oklahoma will evaluate whether proposed pricing and timelines are reasonable, achievable, and consistent with the Bidder’s Proposal.

The State of Oklahoma discourages Bidders from proposing pricing or timelines that cannot reasonably be achieved with the expectation that costs will be recovered through change orders or other post-award mechanisms.

Cost evaluation will include consideration of:

· Alignment between staffing, level of effort, and pricing

· Consistency between timelines, deliverables, and cost

· Completeness of cost components

· Total cost of ownership

If a Cost Proposal is determined to be unrealistic, unbalanced, or not aligned with the Proposal, The State of Oklahoma may adjust scoring, request clarification, or determine the Proposal to present elevated performance risk.

Clarifications requested by The State of Oklahoma are intended to resolve minor ambiguities or inconsistencies and do not permit material changes to the Proposal. Discussions or negotiations, if conducted, may allow Bidders to revise or modify their Proposals as directed by The State of Oklahoma.

Combined Scoring Technical and Cost scores will be combined to determine overall scores. These scores will be used to establish a competitive range and determine which Bidders advance.

Stage 3: Oral Presentations, Reference Checks, and Best and Final Offers (BAFO) The State of Oklahoma may establish a competitive range consisting of the highest-rated Proposals. Only Bidders within the competitive range may be invited to participate in Stage 3.

Stage 3 will include:

· Oral Presentations with capability demonstration

· Reference Checks

· Site Visits (if applicable)

· Best and Final Offers (BAFO) The State of Oklahoma will provide advance notice and instructions for any such activities. Failure to participate in requested Stage 3 activities may result in elimination from further consideration.

The State of Oklahoma reserves the right to:

· Request clarifications at any time

· Conduct discussions or negotiations

· Request BAFOs from any or all Bidders

· Require Oral Presentations and/or Site Visits as part of the evaluation process, including evaluation of key personnel, proposed solutions, and operational capabilities

All costs incurred by Bidders in connection with Oral Presentations, Site Visits, BAFO submissions, or any other Stage 3 activities shall be the sole responsibility of the Bidder. The State of Oklahoma shall not be responsible for any travel, lodging, preparation, or related expenses. A request for BAFO does not guarantee award or further negotiation. BAFO submissions must clearly identify all revisions and will be evaluated using the established criteria.

Stage 4: Apparent Successful Bidder Selection and Contract Negotiation The State of Oklahoma will identify an Apparent Successful Bidder (ASB) based on the evaluation results. Following selection, The State of Oklahoma will enter into contract negotiations with the ASB.

The ASB must provide authorized representatives with full authority to negotiate all contractual terms. If The State of Oklahoma is unable to reach agreement within a reasonable timeframe, The State of Oklahoma may terminate negotiations and proceed to the next highest-ranked Bidder or the Bidder determined to provide the next best value.

Final award is contingent upon successful negotiation and execution of a contract in accordance with State requirements.

Additional Evaluation Provisions The State of Oklahoma reserves the right to:

· Verify information through reference checks and third-party sources

· Consider past performance and experience

· Establish minimum score thresholds

· Request clarification at any time during the process

Information obtained through these methods may be used in scoring and responsibility determinations.

The State of Oklahoma will maintain appropriate documentation of the evaluation process, including scoring, supporting rationale, and any adjustments made during evaluation, to ensure transparency, consistency, and auditability of the procurement process.

Tie-Breaking In the event of a tie, The State of Oklahoma may apply tie-breaking criteria, including:

· Higher technical score

· Higher score in critical categories

· Lower evaluated cost

The State of Oklahoma reserves the right to make a final determination in the best interest of The State of Oklahoma.

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