Summary

This is a Pre-Proposal Network Opportunities Form submission for Indiana's Medicaid Managed Care Organizations Request for Proposal 27-88343, submitted by Anthem Insurance Companies, Inc. (dba Anthem Blue Cross and Blue Shield) through the Indiana Department of Administration. The submission was filed by Mark Voudrie, Staff VP of New Business Development, with contact information provided for coordination purposes. The underlying RFP seeks managed care organization proposals 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. Proposals are due November 6, 2026, with a mandatory pre-proposal conference scheduled for September 10, 2026. The contract term is four years with two optional one-year renewals, for a potential total of six years.

Respondents must demonstrate current MCO service in at least one state and possess at least five years of prior MCO experience, with administrative offices required to be located within five miles of the Indiana Government Center in Indianapolis. The estimated base capitation across all programs exceeds $4.9 billion for the initial rating period. Evaluation will be conducted on 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 (5 points with mandatory preference), and Indiana Veteran Owned Small Businesses (5 points plus 1 bonus point). Contractors must obtain Indiana-licensed health maintenance organization status and NCQA accreditation by contract start or no later than the end of the second full calendar year. Financial requirements include minimum Risk Based Capital ratios of 300 percent per NAIC standards, fidelity bond and professional liability insurance, and commercial reinsurance with attachment points not exceeding $2 million and co-insurance responsibility capped at 20 percent. 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 performance against HEDIS and outcome measures.