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

This is a Pre-Proposal Network Opportunities Form submitted by Anthem Insurance Companies, Inc. dba Anthem Blue Cross and Blue Shield in response to Indiana's Request for Proposal 27-88343 for Medicaid Managed Care Organizations. The Indiana Family and Social Services Administration's Office of Medicaid Policy and Planning is soliciting proposals from managed care organizations to provide statewide risk-based Medicaid services across four programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging, collectively serving approximately 1.5 million Hoosiers. A pre-proposal conference was held on September 10, 2026, with the Pre-Proposal Network Opportunities Form due by September 10, 2026 at 1:30 PM Eastern Time via email to rfp@idoa.in.gov. Written questions are due September 11, 2026, with responses by October 2, and a second round closing October 9, with responses by October 23. The primary proposal submission deadline is November 6, 2026. The contract term is four years with two optional one-year renewals available at the state's discretion, for a potential total of six years.

The total estimated base capitation across all four programs exceeds $4.9 billion for the initial rating period, with state fiscal year 2027 capitation rates ranging from $305.42 PMPM for Hoosier Healthwise to $3,468.29 PMPM for PathWays for Aging. Respondents must demonstrate current MCO service in at least one state and at least five years of prior MCO experience. 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, with administrative offices located within five miles of the Indiana Government Center in Indianapolis. Set-asides include a mandatory Buy Indiana Initiative preference offering 5 points and an Indiana Veteran Owned Small Business subcontracting goal of 3 percent with 5 points plus 1 bonus point available. Contractors must maintain minimum Risk Based Capital ratios of 300 percent per NAIC standards, obtain fidelity bond and professional liability insurance, and purchase commercial reinsurance with attachment points not exceeding $2 million. Compliance performance is tied to a pay-for-outcomes program withholding 1.85-2.25 percent of capitation payments annually from 2029-2034, with estimated recovery of 60-70 percent based on performance against HEDIS and outcome measures. Anthem's primary contact for this submission is Jaedyn Wozniak, Actuarial Analyst III, located at 220 Virginia Ave, Indianapolis, IN 46204.