Opportunity Enterprises.docx

This is a Pre-Proposal Network Opportunities Form submission for Request for Proposal 27-88343 issued by Indiana's Family and Social Services Administration's Office of Medicaid Policy and Planning, seeking managed care organization proposals to serve approximately 1.5 million Hoosiers across four Medicaid programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging. Opportunity Enterprises, headquartered in Valparaiso, Indiana, submitted this form with contact information for Neil Samahon, President & CEO, by the September 10, 2026, 1:30 PM Eastern Time deadline. The primary proposal submission deadline is November 6, 2026, with a pre-proposal conference scheduled for September 10, 2026. Written questions are due September 11, 2026, with responses provided by October 2, and a second question round closing October 9 with responses by October 23. Proposal discussions, oral presentations, and Best and Final Offers are anticipated in May 2027, with an Award Recommendation expected in July 2027. The contract term is four years with two optional one-year renewals, potentially extending to six years total.

Respondents must demonstrate current MCO service in at least one state and at least five years of prior MCO experience, with administrative offices located within five miles of the Indiana Government Center in Indianapolis. Contractors must be Indiana-licensed health maintenance organizations achieving NCQA accreditation by contract start or no later than the end of the second full calendar year of operation. The total estimated base capitation across all four programs exceeds $4.9 billion for the initial rating period, with state fiscal year 2027 rates including Hoosier Healthwise at $305.42 PMPM (for-profit), Healthy Indiana Plan ranging from $228.72 to $1,936.56 PMPM, Hoosier Care Connect at $1,448.47 PMPM, and PathWays for Aging at $3,468.29 PMPM. Evaluation criteria total 90 points (91 with bonus), including Adherence to Mandatory Requirements (Pass/Fail), Management Assessment and Quality (75 points), Oral Presentations (5 points), Buy Indiana Initiative preference (5 points), and Indiana Veteran Owned Small Businesses subcontracting goal of 3 percent (5 points plus 1 bonus point). Contractors must maintain minimum Risk Based Capital ratios of 300 percent per NAIC standards and obtain fidelity bond, professional liability insurance, and commercial reinsurance with attachment points not exceeding $2 million.