RFP 27-88343 - Att I - Pre-Proposal Network Form_BH Anthem.docx

This is a Pre-Proposal Network Opportunities Form submission for Request for Proposal 27-88343, issued by the Indiana 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. The form documents Anthem Insurance Companies, Inc., dba Anthem Blue Cross and Blue Shield as the submitting entity, with contact information provided for Blaire Hadley, Government Relations Director. The pre-proposal form submission deadline was September 10, 2026, at 1:30 PM Eastern Time, with a mandatory pre-proposal conference scheduled for the same date. The formal proposal submission deadline is November 6, 2026, and the contract term extends four years with two optional one-year renewals available, potentially totaling six years of service.

The contract encompasses four distinct Medicaid programs with significant capitation values: Hoosier Healthwise serves approximately 589,000 low-income children and pregnant women at composite PMPM rates of $305.42 (for-profit) and $304.23 (not-for-profit); Healthy Indiana Plan covers approximately 487,000 adults aged 19-64 with rates ranging from $228.72 to $1,936.56 PMPM; Hoosier Care Connect serves approximately 80,000 individuals under age 60 who are blind, disabled, wards, or foster children at $1,448.47 PMPM; and PathWays for Aging covers approximately 115,000 seniors aged 60+ at $3,468.29 PMPM, with total estimated base capitation exceeding $4.9 billion for the initial rating period. Respondents must meet mandatory requirements including current MCO service in at least one state, five years of prior MCO experience, Indiana licensure as health maintenance organizations, NCQA accreditation by contract start, administrative offices within five miles of the Indiana Government Center in Indianapolis, and minimum Risk Based Capital ratios of 300 percent. The evaluation criteria total 91 points, including 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 Business subcontracting goals (5 points plus 1 bonus point). A pay-for-outcomes program will withhold 1.85-2.25 percent of capitation payments annually from 2029-2034, with estimated recovery of 60-70 percent based on HEDIS and outcome measure performance.