FINAL Connector Program RFA FY2027 Final Map 08302025 -.docx

STATE OF MARYLAND

MARYLAND HEALTH BENEFIT EXCHANGED (MHBE)

REQUEST FOR GRANT APPLICATION (RFA#27-01)

Connector Entity Program Grants FY 2027

ISSUE DATE: 12/30/2025

A Prospective Offeror that has received this document from a source other than eMarylandMarketplace Advantage (eMMA) https://procurement.maryland.gov should register on eMMA https://emma.maryland.gov/

MINORITY BUSINESS ENTERPRISES ARE ENCOURAGED TO RESPOND TO THIS SOLICITATION.

STATE OF MARYLAND

MARYLAND HEALTH BENEFIT EXCHANGED (MHBE)

KEY INFORMATION SUMMARY SHEET

750 East Pratt Street, 6th Floor Baltimore, MD 21202

Grant Monitor:

Trina Middleton, Manager, Connector Entity Program Maryland Health Benefit Exchange 750 East Pratt Street, 6th Floor Baltimore, MD 21202 Phone: 443.-388-0519 Email: trina.middleton1@maryland.gov

750 East Pratt Street, 6th Floor Baltimore, MD 21202

Email:

Phone Number:

Shirelle.green1@maryland.gov 410-547-5181

To submit a application, offerors must first register on emma.maryland.gov. We recommend registering in advance to become acquainted with the site.

Video call link: https://meet.google.com/mri-kqws-bhp Or dial:

Offerors are reminded that a completed Feedback Form is requested if a no-bid/proposal decision is made (see Attachment 1 - No Bid Notice/Vendor Feedback Form).

This Request for Applications posted at https://www.marylandhbe.com/solicitations/

Contents

ATTACHMENT I - EVIDENCE-BASED PRACTICES REPORT

I. Solicitation Overview The purpose of this solicitation is to seek proposals from qualified applicants and award grants to organizations who will serve as Prime Entities[footnoteRef:1] in the Maryland Health Benefit Exchange’s (MHBE’s) Connector Entity Program. The Connector Entities (CE) will engage or employ Certified Consumer Assistance Workers to guide community outreach activities; provide in-person application and enrollment assistance for eligible individuals and families seeking health coverage through the state’s web-based insurance marketplace, Maryland Health Connection; and make appropriate referrals for additional assistance. The Maryland Health Benefit Exchange (MHBE) invites proposals from eligible Connector Entity applicants to provide enrollment assistance and consumer support services. Applicants are requested to submit a proposal for the State Fiscal Year (FY) 2027, with one additional one-year renewal option that could extend the term of the grant to June 30, 2028. Funding is a statewide allocation that will be distributed among all Connector Entity regions. A total of six (6) Connector Entities will be selected to fulfill the program’s objectives across designated service regions. Final funding amounts for each selected Connector Entity will be determined based on a combination of factors, including, but not limited to, the region’s size, enrollment volume, demonstrated need, and the strength of the proposed application. [1: See Attachment A (Glossary for the Connector MHBE Connector Entity Program Grants).]

Applicants must provide a detailed budget proposal outlining the allocation of funds in accordance with program requirements. All proposed budgets must align with the scope of work and demonstrate cost-effectiveness in delivering high-quality consumer assistance services. Grants awarded under this solicitation contain federal funding from the Medical Assistance Program, CFDA No. 93.778, as well as State general funds. The State budget generally identifies, in a grant-funding line item, the total amount available for the Connector Entity Program. The MHBE Board of Trustees awards the grants pursuant to powers in its organizing statute and requirements under the ACA.[footnoteRef:2] This solicitation outlines the statutory and regulatory requirements of the Connector Entity Program, explains the goal and conditions of the grant award, and solicits applications from organizations interested in serving as Connector Entities for FY 2027. [2: See Md. Code Ann., Ins. § 31-106(a)-(b), (c)(vi)-(viii); see also, 45 C.F.R. 155.210(a).]

II. Background and Vision The Maryland Health Benefit Exchange (MHBE) is an independent unit of state government responsible for the administration of Maryland Health Connection, the state’s health insurance marketplace, under the Patient Protection and Affordable Care Act of 2010 (ACA) and subsequent state legislation. The MHBE works with the Maryland Department of Health, Department of Human Services, Maryland Insurance Administration, and stakeholders statewide to make insurance affordability programs available to all eligible Marylanders.

The mission of the MHBE is to improve the health and well-being of Marylanders by connecting them with high-quality, affordable health coverage through innovation, technology, and customer service. We value diversity, innovation, collaboration, and the highest standards of professional ethics. To that end we issue the following Request for Applications seeking qualified Grantees to provide Consumer Assistance Workers application, enrollment, and outreach services under the CE program.

The first year of this new grant period will coincide with the MHBE’s 14th open enrollment period. In the first few years, MHBE focused particularly on outreach services from the CE program, as the Affordable Care Act and the state marketplace were brand new concepts to Marylanders. More recently, and in particular in response to the COVID years, outreach efforts at the local level have diminished and application services expanded, consistent with the long open enrollment and special enrollment periods provided to Marylanders during the pandemic. As it approaches its 13th anniversary of open enrollment and looks forward to the next two years, the MHBE seeks to re-balance the CE program to return focus to local outreach efforts and concentrate application and enrollment services on new enrollees. Despite recent record enrollment, Maryland continues to carry pockets of uninsured, including the “hard to convince.” Thus, this RFA will ask current and new applicants to reconsider how the Consumer Assistance Workers program can bring value to the local community through hyper-local outreach hubs. Only by firmly embedding health coverage in community care will the hard to reach come to trust the “get covered, get connected, get care” message that has been central to the mission of the CE program since 2013.

The RFA outlines certain requirements, assumptions, and expectations, but the MHBE also invites applicants to suggest alternative approaches if they can demonstrate an effective strategy for meeting the overall goal of increased outreach and lower numbers of uninsured. The MHBE seeks grantee partners that will embrace a holistic, community-centered approach to services while responding effectively to rapidly evolving changes in technology, policy, and customer service level needs. The grantee should demonstrate their willingness to be flexible and transparent in all aspects of engagement with this project.

III. Program Description

The Maryland Health Benefit Exchange Act of 2012 (the “Maryland Act”) established, among other things, a Consumer Assistance Workers program to provide in-person assistance to individuals seeking coverage through the Individual Exchange in the State of Maryland. Building on the ACA, the Maryland Act defines the duties of Consumer Assistance Workers and non-certified personnel, the criteria for becoming a Consumer Assistance Workers, and the oversight and enforcement mechanisms for the connector program.[footnoteRef:3] The Maryland Act directs MHBE to retain entities that have expertise in working with vulnerable and hard-to-reach populations.[footnoteRef:4] As directed by the Maryland Act, the Maryland Insurance Administration (MIA) has regulatory oversight over Connector Entities and certified Consumer Assistance Workers.[footnoteRef:5] [3: See Md. Code Ann., Ins. (“Ins.”) § 31-113.] [4: See Ins. 31-113(b)(2)(i).] [5: See Ins. 31-113(a)(2)(g)(I).]

The primary goal of the Connector Program is to guide community outreach activities related to enrolling eligible, hard to reach populations such as minorities, those with limited English proficiency, limited access to computers, or who possess low literacy rates into Medicaid, the Maryland Children’s Health Program, and Qualified Health Plans (QHPs). MHBE seeks organizations that are qualified, either individually or in partnership with other organizations, to direct hyper-local, community-focused outreach in MHBE-defined areas of persistently uninsured; provide in-person or telephone/video chat application, enrollment, and retention assistance as preferred by local consumers; and help Marylanders who have traditionally struggled to connect to or afford health coverage.

A. Prime Entities and Partnerships. Under Maryland law, the Connector Entity is either a single organization or a partnership of entities.[footnoteRef:6] A Connector Entity must be authorized by MHBE to employ or engage Individual Exchange Consumer Assistance Workers.[footnoteRef:7] Where a partnership of entities is formed, one MHBE-authorized organization serves as the Prime Entity. The Prime Entity may solicit formal partners and enter into a partnership of entities agreement with such partners. Only those partners in the partnership of entities may employ or engage Consumer Assistance Workers. All organizations that enter the partnership of entities will be subject to the same agreement terms and conditions as the applicant/Prime Entity and will be subject to regulatory oversight by the MIA. The CE may also seek informal community partners to engage in outreach activities. As long as these partners employ or engage non-certified personnel only (i.e., do not employ or engage Consumer Assistance Workers) they are not required to join the partnership of entities. [6: Ins. § 31-101(i).] [7: Ins. §§ 31-101(j), 31-113(f).

The Prime Entity is responsible for submitting the Connector Entity’s grant application and, if successful under this solicitation, signing a Connector Entity agreement with MHBE, directing and reporting on the Connector Entity’s program activities, administering its budget and reporting on its expenditures, ensuring the compliance of all of its partners with applicable laws and regulations, and serving as the Connector Entity’s point of contact with the MHBE. A community organization with service areas in more than one Connector Entity region, however, may be named as a non-Prime partner on more than one grant application.

B. Regions. For FY 2027, the Connector Entity program will continue under a regional framework, with some modifications to address particular attention to remaining areas of persistently uninsured and to shift resources to best serve consumers and the needs of the program. The regional approach has proven effective in leveraging community partner relationships and resources as well as efficiently extending MHBE activities in marketing, system training, and partner support, using the Prime Entity as the point of contact for distributing information within the region and reporting back challenges and best practices to MHBE. In addition, the regional approach ensures that populations are being served by individuals and organizations familiar with the local communities. Below are the updated Regions for FY2027. Regions are as follows:

· West: Garrett, Allegany, Washington, Frederick, Carroll

· Capital North, Montgomery

· South: PG County

· Central: Baltimore City, Baltimore County, Howard, Anne Arundel

· Lower Shore: Queen Anne’s, Talbot, Caroline, Dorchester, Wicomico, Somerset, Worcester

· Upper Shore/Southern: Charles, St. Mary’s, Calvert, Cecil, Harford and Kent

C. Eligible Entities. All Connector Entity Program applicants must provide information in their applications showing that they meet the following eligibility criteria:

1. Demonstrate the entity has existing relationships, or could readily establish relationships, with consumers (including uninsured and underinsured consumers) likely to be eligible for enrollment in health coverage programs offered through the MHC.[footnoteRef:8] [8: See 45 C.F.R. § 155.210(c)(1)(ii); 31-113(c).]

2. Demonstrate the entity has existing relationships, or the ability to readily establish relationships, with entities engaged in expanding health coverage to individuals, including relationships with community partners, local agencies, providers and others in the region.

3. Demonstrate that, on July 1, 2026, the entity will have sufficient infrastructure to house (hybrid work models accepted) and manage program staff; collect and report outreach and enrollment statistics; provide a local telephone number or numbers for consumers to reach a Consumer Assistance Workers by phone; and track expenditures and submit invoices timely and accurately. With an approved detailed work plan, applicants may be granted a transition period up to an additional three (3) months (July 1-September 30) to become fully operational.

4. Demonstrate ability to comply with the privacy and security standards adopted by MHBE under 45 C.F.R. § 155.260, including requirements that individuals with access to personally identifiable information certify their compliance with the adopted standards.

5. Demonstrate ability to comply with the conditions set out in the Grant Agreement, including Attachment E- Federal Funds Requirements and Restrictions and Attachment F – Connector Entity Partner Conflict of Interest Affidavit and Disclosure.

The following entities are not eligible to participate in the Connector Program:

1. Individuals or entities who hold a license issued by the Maryland Insurance Administration

2. Health insurance issuers, stop loss issuers or their subsidiaries

3. Managed Care Organizations

4. Associations that include members of, or lobby on behalf of the insurance industry

5. Recipients of any direct or indirect consideration from any health insurance issuer or stop loss issuers in connection with the enrollment of individuals in private health plans.

D. Program Components.

The MHBE has established “High Focus Meta Areas” in specific communities across the State where rates of the persistently uninsured are high. Grantees are to establish a Community Service Center within these communities to support community outreach and enrollment assistance activities. These centers are to be developed in the following Communities noted on the left in the chart below. ZIP codes are provided for further guidance.

The MHBE believes that only by becoming part of these communities will a CE program be successful in becoming a trusted messenger for health care coverage, particularly among the persistently uninsured and hard to convince. As such, we are looking for Grantees who know these areas well and are willing to create “go to” centers for the community. Examples of community-centered partnerships might include:

· Creating a space for a weekly farmers micro market

· Providing a computer/copier/fax for drop in use

· Having a weekly story hour for children and/or a lending library

· Creating partnerships with Federally Qualified Health Centers (FQHC)

· Partnering with Community Health Workers to offer blood pressure checks

· Partnering with the LHD to offer flu shots

· Organizing a neighborhood clean-up

· Hosting a Monthly Poetry Slam

· Establish relationships with local trade schools and workforce development centers to identify both W-2 and 1099 employees for potential health exchange enrollment

· Providing free toothbrushes (find a partner to provide)

· Hosting enrollment events in community schools to offer application support to mixed household compositions. Sponsoring a chalk art sidewalk competition on the first day of Spring – you provide the chalk and the prizes, get local art students to help

· Partnering with local libraries to host in-person application and enrollment assistance

· Invite local students to “decorate” your new space with artwork – you provide the supplies

· Setting up a high school student intern program

· Distributing calendars of events, along with Consumer Assistance Workers availability, on a regular basis, door to door

· Attending community/church/food bank events

· Providing space for outreach and enrollment partners such as caseworkers, producers, and application counselors to facilitate warm hand-offs Applicants should consider the following questions when responding to this RFA: What does your target area need? Who will you partner with to ensure cultural and linguistic appropriateness? How will you create an atmosphere of respect, caring, and affirmation?

In addition, the CEs will engage or employ Consumer Assistance Workers and other personnel to perform the following duties:

· Provide access to in-person application and enrollment assistance related to health coverage options offered on Maryland Health Connection.

· Provide referrals to appropriate agencies, including the Attorney General’s Health Education and Advocacy Unit (HEAU) and the Maryland Insurance Administration (MIA), for applicants and enrollees with grievances, complaints, questions or the need for other social services.

· Work collaboratively with local government agencies in each jurisdiction in the region to optimize the consumer experience and ensure that consumers are enrolled in appropriate health insurance coverage.

· Provide all information and services in a manner that is culturally and linguistically appropriate and ensures accessibility for individuals with disabilities.

Outreach staff will work primarily in the meta-areas defined above, using a physical space within the High Focus Meta Areas established by the CE as the Community Service center or hub. Grantees should make every effort to hire outreach staff from within the community where the service center is located. Consumer Assistance Workers may be organized around a hybrid work model if the plan includes in-person assistance as appropriate to the community. Video appointments assisted from the Community center are also permitted and may be encouraged if appropriate to the community. Facilities should include private space for application and enrollment activities. Consumer Assistance Workers should also be focused on the meta-areas but will also need to be available upon request by residents throughout the CE region. There may be times when requests for assistance exceed capacity; applicants should plan a strategy for triage and appropriate referrals during times of high volume.

Each region should plan to staff one Program Director and one Community Outreach Director. Titles may vary, but each entity may have only one individual in each position.

“Unfunded” Consumer Assistance Workers (funded by a partner in the partnership of entities with non-grant funds) are permitted, but the CE should fully explain how oversight responsibilities will be met by the Prime entity.

To ensure the most effective and efficient use of taxpayer dollars, Maryland Health Benefit Exchange has established the following annual salary caps for staff supported by this funding opportunity:

· Program Managers: Up to $130,000 annually for contract period

· Supervisors/Outreach Managers: Up to $95,000 for annually for contract period

· Consumer Assistance Workers/Consumer Assistance Workers Leads: Up to $80,000 annually for contract period These salary caps are based on statewide averages for comparable roles and are designed to promote responsible stewardship of public funds while supporting adequate staffing across all regions served. The primary objective of this salary cap policy is to allow funding to support the maximum number of qualified personnel focused on Maryland Health Connection’s enrollment efforts. By placing reasonable limits on salaries, more funds can be directed toward hiring additional Consumer Assistance Workers and enrollment staff. Applicants must align their budget proposals with these caps and justify staffing structures that prioritize service coverage and performance outcomes.

Outreach workers may be employed or engaged by community partners and do not necessarily have to be directly employed by the CE. Outreach staff should be hired, where possible, from within the community service area. Outreach staff may (and should) receive training, but do not have to test and will not be certified.

Fringe benefits are allowable in proportion to the salary charged to the grant. All applicants must provide CE program staff with high quality, affordable health care coverage either through sponsoring a group health program or providing pre-tax dollars equal to the cost of QHP coverage on the Maryland marketplace. Although outreach workers do not have to be directly employed by the CE, the CE must ensure that whoever does employ or engage outreach workers meets the health care coverage requirement.

Applicants are allowed 15% of invoiced amounts in indirect costs each month. See budget section below.

The MHBE anticipates distributing the not-to-exceed budget of $9.1 million dollars for FY27 through these Grant awards contingent upon approved bids and MHBE does not have a predetermined amount for each Region to receive in a Grant award.

IV. Program Conditions A. General Oversight. Connector Entities will be expected to participate in routine check in calls with MHBE. The purpose of these calls will be to monitor entity effort, address entity concerns or issues, address information systems questions or challenges, and generally provide for open communication between the entity and the MHBE. Connector Entities shall also attend meetings at the request of the MHBE and be available for on-site visits by the MHBE. On site visits will include a review of financial and personnel documents and compliance practices. Connector Entities and their partners also must make such records available to federal and State auditors upon request. All records, paper, electronic, or other media, relating to grant activities must be retained for 10 years.[footnoteRef:9] [9: 45 C.F.R. § 155.1210.]

B. Program Activities/ Conditions of Award. Applicants’ proposals must reflect comprehensive consumer assistance services[footnoteRef:10] and the following activities, which are ongoing conditions of grant award: [10: See Ins. 31-113(c); 45 C.F.R. § 155.210(c), (e).]

1. Ensure all Consumer Assistance Workers employed or engaged are properly trained and certified, as required under COMAR 14.35.02 et seq., including meeting annual and continuing education requirements, and,

2. Maintain accurate lists of the Consumer Assistance Workers in the region, secure and maintain any Consumer Assistance Workers attestations MHBE requires as part of the Consumer Assistance Workers application and certification processes under COMAR 14.35.02 et seq. or 14.35.03 et seq., and provide the MHBE with timely notification regarding onboarding or terminating of Consumer Assistance Workers staff.

3. Obtain a DUNS number and register in the Federal Funding Accountability and Transparency Act Subaward Reporting System.

4. Participate in meetings and calls hosted by MHBE and share information with the enrollment community in the region;

5. Maintain a physical location and presence in the region; if an organization is grantee for more than one region, it must have a main location and lead person in each region;

6. Maintain expertise in eligibility, enrollment, and program specifications for Maryland insurance affordability programs offered through Maryland Health Connection, including Medicaid, MCHP and Private Health Plans;

7. Provide information and services in a fair, accurate and impartial manner, which includes providing information that assists consumers with submitting the eligibility application; clarifying the distinctions among health coverage options, including QHPs, and helping consumers make informed decisions during the health coverage selection process;

8. Provide advice and appropriate referrals to consumers experiencing issues with the Maryland Health Connection online system, and follow procedures established through MHBE’s escalation process;

9. Initiate and guide community outreach planning in the high-focus meta area to ensure a coordinated and strategic effort, with special emphasis on reaching the uninsured;

10. Follow state-wide marketing and branding guidelines provided by the marketing team and attend scheduled meetings to coordinate marketing efforts.

11. Work with MHBE’s Marketing Team on two open enrollment events each year, which includes coordinating local space, local marketing, and staffing the event with Certified Consumer Assistance Workers and other appropriate staff;

12. Submit to the MHBE Marketing Team the contact information of consumers who have been asked and agreed during a post-enrollment debrief if they would volunteer to share their story for marketing purposes; alternatively, shoot a “person on the street” video of the consumer’s experience (with their approval to share), and submit video to marketing team;

13. Work collaboratively with local government agencies, insurance producers, and Application Counselor Program Organizations in each jurisdiction in the region to ensure consumers obtain the most appropriate, effective, and timely service;

14. Provide referrals to appropriate agencies including the Attorney General’s Health Education and Advocacy Unit, the MIA, and local departments of social services for applicants and enrollees with grievances, complaints, questions, or the need for other social services;

15. Meet regularly with the Local Health Departments and Local Department of Social Services for the counties in the region to support consistency with MHBE/MDH policies and HBX use across caseworkers and Consumer Assistance Workers;

16. Provide information in a manner that is culturally and linguistically appropriate, including to individuals with limited English proficiency, and individuals with disabilities;

17. Enter all consumer information related to application and enrollment in the Maryland Health Connection website following security and confidentiality standards established by the Exchange;

18. Ensure voter registration assistance is available as directed by the MHBE;

19. Act as the funding agent for entity partners and other subcontractors in compliance with the approved budget and submit detailed support for expenditures as directed by the MHBE;

20. Make time available for the MHBE Compliance Office to conduct on-site surveys to ensure Connector Entities have policies, procedures and practices that comply with grant conditions. The Grantee shall submit and implement a corrective action plan within 30 days for on-site survey findings of non-compliance. On-site surveys will be conducted on an annual basis and may be more frequent, at the discretion of the MHBE;

21. Ensure that each member of the Partnership of Entities adheres to the activities and requirements delineated in the RFA; each partner entity is subject to the Prime Entity’s procedures for monitoring partner quality performance and program integrity. These include but are not limited adherence to applicable State and federal regulations; measures in place to detect and prevent fraud, waste, and abuse; and ensuring compliance with MHBE’s privacy and information technology security policies;

22. Comply with notification and approval conditions related to change in control of the Prime Entity, as further described in the Grant Agreement – Attachment C.

23. Ensure that any organization that participates in, or constitutes, a Connector Entity and is also an Application Counselor Program Organization abides by the requirements in COMAR 14.35.12.04.D to segregate each program’s staff and funding from the other program, as well as to allocate costs as directed.

C. Insurance Conditions. All insurance required by this section shall be effective when the Grant Agreement commences and shall remain in effect during the project period and renewal option periods, if exercised.

For any item of real or personal property that is acquired with Grant funds and has an original fair market value of Five Thousand Dollars ($5,000) or more, the Grantee shall, at its own expense, and for the reasonable useful life of that item or for 54 years, whichever is less, obtain and maintain insurance. The insurance shall provide full protection for the Grantee and the State against loss, damage, or destruction of or to the real or personal property. The Grantee shall, on request, provide the MHBE with satisfactory evidence of its compliance with this requirement. Proceeds from insurance required by this paragraph shall be applied toward replacement of the real or personal property or toward the partial or total repayment to the MHBE of the Grant, in the sole discretion of the MHBE.

The Grantee shall maintain Commercial General Liability Insurance with limits sufficient to cover losses resulting from or arising out of Grantee action or inaction in the performance of the Agreement by the Grantee, its partners, agents, servants, employees or subcontractors, but no less than a Combined Single Limit for Bodily Injury, Property Damage and Personal and Advertising Injury Liability of $1,000,000 per occurrence and $3,000,000 aggregate.

In the event the Grantee hires or engages licensed professionals to perform any aspect of the project activities, Grantee shall maintain Errors and Omissions/ Professional Liability insurance with minimum limits of $1,000,000 per occurrence.

The Grantee shall maintain Automobile and/or Commercial Truck Insurance as appropriate with Liability, Collision and PIP limits no less than those required by the State where the vehicle(s) is registered but in no case less than those required by the State of Maryland. If automotive equipment is required in the performance of this Agreement, automobile bodily injury liability insurance with a limit of not less than $30,000 for each person and $60,000 for each accident, and property damage liability insurance with a limit of not less than $15,000 for each accident shall be required.

The Grantee shall maintain Employee Theft Insurance with minimum limits of $1,000,000 per occurrence.

The Grantee shall maintain such insurance as necessary and/or as required under Worker’s Compensation Acts, U.S. and the Federal Employers Liability Act as well as any other applicable statue.

Grantee shall maintain up-to-date insurance certificates on file with MHBE, as required in RFA § III.C. Should insurance lapse or cancel, Grantee shall notify MHBE immediately.

Grantee shall ensure that all partners in any partnership of entities of which the Grantee is a Prime Entity are also in compliance with the insurance requirements in this section.

Failure to comply with the insurance requirements of this Section 7 and RFA § III.C may result in termination of this Agreement.

D. Additional Post-award conditions. Applicants should note the following post-award conditions:

1. The Grantee shall comply with all applicable State and federal law, regulation and guidance, including the ACA, the Maryland Health Benefit Act of 2012 and the Maryland Health Progress Act of 2013, and all regulations promulgated thereunder; and laws and regulations associated with the receipt of federal Medical Assistance Funds (see Attachment E).

2. Grantees shall work with the MHBE to finalize the enrollment targets, staffing plan, and outreach strategies outlined in their applications. Grantees who are awarded a grant for more than one region must develop separate plans to meet the specific needs of each region.

3. Grantees shall follow the MHBE procedures regarding privacy and security breaches, as described in the Non-Exchange Entity Agreement attached as Attachment D;

4. Consumer Assistance Workers candidates must not be on the List of Excluded Individuals/Entities maintained by the DHHS Office of Inspector General.

5. Grantees shall comply with MHBE’s performance measurement and reporting requirements, identified in Section IV, below.

6. Final grantees and award amounts will be at the discretion of the MHBE and are subject to available funding, as further described in the Grant Agreement attached as Attachment C.

IV. Performance Measurement and Reporting

Connector Entities will be required to submit quarterly reports which track project status, partner engagement, outreach efforts, customer satisfaction and referrals to MIA and HEAU. If the organization has been awarded a grant for more than one region, reports must be submitted separately for each region. Quarterly reports will be due 30 days after the end of the quarter. Quarters end on September 30th, December 31st, March 31st, and June 30th of each fiscal year.

A. Program-Related Metrics. Connector Entities will report on the following program-related activities on a quarterly basis:

· Involvement with partners

· Interaction with health insurance brokers

· Number of calls received by CE during the quarter

· Number of appointments scheduled by CE during the quarter

· Number of group presentations made by CE staff during the quarter

· Events Hosted – in-person or virtual

· Events Attended

· Events held with Partner or other organization

· Earned Media – articles or posts

· Social Media – posts generated by Prime or Partner

· Number of referrals to MIA by CE during the quarter

· Number of referrals to HEAU by CE during the quarter B. Enrollment targets. Enrollment Targets for NEW Qualified Health Plan (QHP) enrollment have been set for each region for fiscal year 2027.

Anne Arundel, Howard 22,333

2,712

5,712

New enrollments include all enrollments in the area or region of CE responsibility, whether final enrollment is completed by consumer, Consumer Assistance Workers, or other type of consumer assistance worker. “New” enrollments are defined as:

· any insurance affordability program enrollment for a person not currently enrolled in Maryland Health Connection, and

· any QHP enrollment for a consumer who was enrolled in Medicaid but is no longer eligible for Medicaid

C. Performance Monitoring for FY 2027

The following metrics will be used to monitor performance of the Connector Entities.

Application Outcome Points

The outcome of all applications submitted by the CEs during FY27 will be monitored by MHBE CE Program Manager and by each CE. CEs will be required to develop a process to ensure two outreach/follow-up attempts are presented to consumers in an Application Initiated or Application Submitted status with a goal of assisting with application completion.

FY 27 Application Outcome Point System

Recommended Connector Application Outcome and Referral Points

Outreach Assessment. Connector Entities will be assessed on engagement based on the number of outreach events conducted. Applicants must outline their outreach strategy, including the frequency and types of events planned to effectively engage, educate and offer application/enrollment assistance to consumers. The Connector Entity Program Manager will evaluate performance by monitoring CE Quarterly Outreach data and assess the impact on consumer awareness and enrollment. Outreach Activities to be assessed include but are not limited to:

· Community engagement

· Hosting or attending events

· Collaborations with local organizations

· Direct outreach

· Q&A Sessions with Consumer Assistance Workers

Outreach Reports including the date, type, and description of the outreach activity should be submitted with the grantee’s quarterly report.

D. Customer Satisfaction Metrics. Connector Entities may continue to collect but are not required to report on the FY 2027 Customer Satisfaction indices. Measurement of customer satisfaction for the new outreach component is to be developed.

E. Standardized Assessment of Consumer Assistance Workers MHBE will continue the initiative to standardize the assessment of certified Consumer Assistance Workers. The aim of this initiative is to use the same criteria to assess Consumer Assistance Workers across all CEs -- prime and partners, funded or unfunded. The goal is to promote the high quality of Consumer Assistance Workers activity across the regions. In the initial phase which takes place after Open Enrollment, MHBE distributes an online self-assessment for each certified Consumer Assistance Workers to complete. In the second phase, MHBE provides the opportunity for the Consumer Assistance Workers' program supervisor to assess the Consumer Assistance Workers on the same questions through an online questionnaire. All results are shared with the CE.

V. Financial Conditions

A. Use of Funds. Grantee’s award funding must only be used to conduct the Consumer Assistance Workers Program activities and services contained within the Grant Agreement. Funds may be used to perform the following activities: outreach, education, enrollment and post enrollment support to eligible consumers and technical assistance to regional partners. Grant funds shall be expended in accordance with an MHBE approved budget. Recipients are required to report deviations from budget or project scope or objective and request prior written approval from the MHBE for program plan revisions or changes in the budget – between line items or to a new line item - involving $100.00 or more. For invoices to be processed, Connector Entities must have a fully executed Grant Agreement in place with MHBE and be current on all programmatic and financial reporting requirements.

Any acquisitions made with grant funding shall follow state and federal law. Consumer Assistance Workers Program grant funds shall not supplant federal, state or private funds allocated to conduct the same or similar work contained within the Grant Agreement. Connector Entities will be expected to ensure that services are provided with the highest level of ethical, business, and legal standards. Connector Entities, as well as their employees and employees of their partners, have the responsibility to act with integrity, honesty, and transparency.

B. Federal funds. The resulting Grant Agreements will contain federal funds from CFDA number 93.778 titled “Medical Assistance Program.” CEs must follow all requirements associated with the receipt of Medical Assistance Funding under CFDA 93.778, including those in the Federal Funds Requirements and Restrictions Attachment (Attachment E). Entering into a Grant Agreement awarded as a result of this RFA, and acceptance of grant funds, indicates the Applicant’s agreement that it will comply and ensure its partners comply with all federal funding terms and conditions that apply to Medical Assistance.

C. Payment. The MHBE will make reimbursable payments for expenditure incurred on a monthly basis throughout the grant term. Invoices that detail expenditures by category as included in the budget proposal can be submitted as early as the 15th day of the billing month but no later than the 20th of the same month by submission to HBE.finance@maryland.gov. Invoices must include the CE/Grantee’s name, address, and fiscal contact, invoice date, Federal Tax ID number, and a unique invoice identification number.

Invoices must be accompanied by all relevant documentation supporting expenditures detailed in the invoice, including records that support payroll and payroll related expenses.

Additionally, financial reports must be submitted at the end of each quarter that adequately identify the application of funds to Consumer Assistance Workers program activities, including expenditures, obligations, authorizations, and unobligated balances. Please note, only expenditures should be included on the monthly invoice presented for payment. CEs must provide regular reports as required by the MHBE, including a verified report on its expenditure of State aid, as required by Md. Code Ann., State Fin. & Proc. § 7-402, as well as keep financial records in accordance with generally accepted and uniform accounting standards and principles, as required by State Fin. & Proc. § 7-403.

The MHBE reserves the right to withhold payment, or require repayment, of any expenditure not approved in the Connector Entity’s original or revised work plan approved by the MHBE, or that is not consistent with the purposes of the grant as stated in this RFA. Further, MHBE reserves the right to re-evaluate future funding based on a Connector Entity’s failure to reach targeted goals as outlined in the grantee’s application and work plan approved by MHBE, or failure to submit timely financial or performance measurement reports.

D. Termination. MHBE may terminate the Grant Agreement with any grantee that does not comply throughout the grant period with the entity eligibility requirements, conflict of interest standards, grant award conditions identified in the grant agreement resulting from this RFA, and all applicable State and federal statutes and regulations.

E. Extension. No extension shall be allowed for the expenditure of grant funds that are identified in a Connector Entity’s approved budget but have yet to be spent at the end of the grant period.

F. Administration of funding. Grantees must directly administer the grant funds. No grant funds will be disbursed to any organization or entity, whether or not formed by the Grantee, other than as specifically set forth and agreed to in the Grant Agreement. Line items on invoices must align with line items in the approved budget contained in the fully executed Connector Program Grant Agreement, or in an approved modification.

G. Indirect Costs: Prime entities must limit indirect costs to 15% of invoiced amount. Indirect costs include costs that are not directly associated with enrollment activities yet contribute to the support of the program such as compliance, fiscal, legal, executive, and administrative staff. A delineation of what is contained in indirect costs must be included in the “Narrative/Description/Justification” section of the budget template.

VI. Application Process and Schedule A. Grant Schedule. The following table outlines the schedule for important dates and activities. Unless otherwise stated, the deadline for all scheduled activities is 5:00 p.m. Eastern Standard Time on the specified date.

Changes will be posted at https://www.marylandhbe.com/solicitations/

Grant Contract Extension (3 months) for MHBE Board Approval

Monday, September 15, 2025

Notification of Intent to Award Grant Contract Extension (3 months)

Friday, October 10, 2025

Initial CMS CE RFA Review (Up to 60-Day Review Period)

September 30-October 31, 2025

CMS CE RFA Award Review (Up to 60-Day Review Period)

Monday, January 19 to March 23, 2026

Meeting schedule pending

B. Grant application telephone conference/ virtual meeting. Potential applicants are strongly encouraged, but not required, to attend a pre-application virtual meeting regarding the Grant Application on Tuesday, September 9 · 2:00 – 3:00pm Google Meet joining info. Video call link: https://meet.google.com/ktq-wxoy-zuo Or dial: (US) +1 803-999-5599 PIN: 444 454 280#

C. Letter of Intent to Respond. Potential applicants must submit a Letter of Intent to Respond by email to the Single Point of Contact identified in the Key Information Summary Sheet, above, by the date and time specified in the Grant Application Schedule. The Letter of Intent should conform to the following guidelines:

∙ Be provided on the organization’s letterhead;

∙ Identify a single contact person, including their first and last name, title, email address and direct phone number;

∙ Be signed by a person who is authorized to bind the organization in a potential future agreement;

∙ Indicate the region for which the applicant intends to apply; and ∙ Submit a separate Letter of Intent for each region for which the applicant intends to apply

The MHBE strongly encourages organizations to send the Letter of Intent as soon as the entity believes it will be applying for the Grant Program. A list of organizations that have submitted Letters of Intent will be posted on the MHBE website https://www.marylandhbe.com/solicitations/ for those interested in a collaboration or partnership among interested organizations unless an organization requests otherwise in its letter.

D. Grantee questions and clarification. The MHBE will accept written questions or concerns related to this Grant Application and/or its accompanying materials, instructions, or requirements, until the date and time specified in the Grant Application Schedule. Applicants are encouraged to send questions as they arise. Applicants must not call with questions. Organizations may submit questions by e-mail to the Single Point of Contact. Please reference “Connector Entity RFA” in the subject line when submitting inquiries. The MHBE may, at its sole discretion, post questions and responses at the date and time specified in the Grant Application Schedule.