RFP_S-44000-00009689_Market Stabilization Actuarial Services~1.pdf

RFP Solicitation #: S-44000-00009689 Market Stabilization Actuarial Services

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STATE OF OREGON

COVER PAGE

Department of Consumer and Business Services

Division of Financial Regulation

Is issuing this Request For Proposals (RFP) under OregonBuys Bid Number S-44000-00009689 for

HEALTH INSURANCE MARKET STABILIZATION

ACTUARIAL SERVICES

Date of Issue: November 21, 2024

Bid Opening Date and Time: December 31, 2024

Single Point of Contact (SPC): Daniel Robinson, Procurement and Contract Specialist

Address: 350 Winter Street NE, Room 2 City, State, Zip: Salem, OR 97301 Phone: (503) 302-9747 Email: daniel.k.robinson@dcbs.oregon.gov

The State of Oregon promotes equal opportunity for all individuals without regard to age, color, disability, marital status, national origin, race, religion or creed, sex or gender, sexual orientation, or veteran status

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TABLE OF CONTENTS

SECTION 1: GENERAL INFORMATION

1.1 INTRODUCTION

1.2 SCHEDULE

1.3 SINGLE POINT OF CONTACT (SPC)

1.4 OREGONBUYS

SECTION 2: AUTHORITY, OVERVIEW, AND SCOPE

2.1 AUTHORITY AND METHOD

2.2 DEFINITION OF TERMS

2.3 OVERVIEW AND PURPOSE

2.4 SCOPE OF WORK/SPECIFICATIONS

SECTION 3: PROCUREMENT REQUIREMENTS

3.1 MINIMUM QUALIFICATIONS (Pass/Fail)

3.2 MINIMUM SUBMISSION REQUIREMENTS (Pass/Fail)

3.3 PROPOSAL REQUIREMENTS

SECTION 4: SOLICITATION PROCESS

4.1 PUBLIC NOTICE

4.2 PRE-PROPOSAL CONFERENCE

4.3 QUESTIONS / REQUESTS FOR CLARIFICATIONS

4.4 SOLICITATION PROTESTS

4.5 PROPOSAL DELIVERY OPTIONS

4.6 PROPOSAL MODIFICATION OR WITHDRAWAL

4.7 PROPOSAL DUE

4.8 PUBLIC OPENING

4.9 PROPOSAL REJECTION

4.10 EVALUATION PROCESS

4.11 RANKING OF PROPOSERS

SECTION 5: AWARD AND NEGOTIATION

5.1 AWARD NOTIFICATION PROCESS

5.2 INTENT TO AWARD PROTEST

5.3 APPARENT SUCCESSFUL PROPOSER SUBMISSION REQUIREMENTS

5.4 PRICE AGREEMENT NEGOTIATION

SECTION 6: ADDITIONAL INFORMATION

6.1 COMMITMENT TO DIVERSITY, EQUITY, AND INCLUSION

6.2 CERTIFIED FIRM PARTICIPATION

6.3 GOVERNING LAWS AND REGULATIONS

6.4 OWNERSHIP/PERMISSION TO USE MATERIALS

6.5 SOFTWARE SECURITY AND HOSTING

6.6 CANCELLATION OF RFP; REJECTION OF PROPOSAL; NO DAMAGES

6.7 COST OF SUBMITTING A PROPOSAL

6.8 STATEWIDE E-WASTE/RECOVERY PROCEDURE

6.9 RECYCLABLE PRODUCTS

6.10 CHECKLIST DISCLAIMER

SECTION 7: ATTACHMENTS

ATTACHMENT A – SAMPLE PRICE AGREEMENT

ATTACHMENT B - DISCLOSURE EXEMPTION AFFIDAVIT

ATTACHMENT C - PROPOSER INFORMATION AND CERTIFICATION SHEET

ATTACHMENT D - REFERENCE CHECK FORM

ATTACHMENT E - PRICE PROPOSAL FORM

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ATTACHMENT F - COBID CERTIFICATION / OUTREACH PLAN

ATTACHMENT G - RESPONSIBILITY INQUIRY

ATTACHMENT H – KEY PERSONS EXHIBIT

ATTACHMENT I – PROPOSER CHECKLIST

SECTION 1: GENERAL INFORMATION

1.1 INTRODUCTION

The State of Oregon, acting by and through the Department of Consumer and Business Services, Division of Financial Regulation, (“Agency”), is issuing this Request for Proposal under the provisions of ORS 279B.060 for qualified Proposers to provide actuarial consulting services to support the Agency’s consideration of proposed strategies intended to help maintain a stable and robust commercial health insurance marketplace by suppressing premium rates and increasing competition in the commercial marketplace in every county throughout the State of Oregon.

This RFP is primarily concerned with commercial health insurance markets. However, legislative proposals may raise issues that affect the commercial health insurance markets along with governmental employee health plans, Medicaid, Medicare Advantage, workers’ compensation health care, or other health risks markets. Although such assignments are not currently contemplated, such issues are within the scope of the RFP.

Additional details on the Scope of the goods or services or both are included in the Scope of Work/Specifications Section 2.4.

Agency anticipates the award of one Price Agreement from this RFP. The initial term of the Price Agreement is anticipated to be two (2) years with options to renew up to a cumulative maximum of ten (10) years.

Work Order Contracts (WOC) issued by Agency in accordance with the ordering procedures described in Attachment A, Sample Price Agreement, must authorize any Services under the Price Agreement. Proposers are advised there is no guarantee of any specific quantity of Services under the Price Agreement. Notwithstanding the award of a Price Agreement, Agency may conduct separate solicitations or award project-specific contracts or purchase orders for services similar to what is described within this RFP using any method allowed by law.

1.2 SCHEDULE

The table below represents a tentative schedule of events. All times are listed in Pacific Time. All dates listed are subject to change. N/A denotes that event is not applicable to this RFP.

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Event Date Time

Pre-Proposal Conference N/A N/A

Questions / Requests for Clarification Due December 10, 2024 10:00 AM

Answers to Questions / Requests for Clarification Issued (approx.) December 13, 2024

RFP Protest Period Ends 7 calendar days prior to RFP Bid Opening Date

Bid Opening (Proposal Due) See RFP cover page

Opening of Proposal December 31, 2024 3:00 PM

Presentations, Demonstrations, or Interviews N/A

Issuance of Notice of Intent to Award (approx.) January 31, 2025

Award Protest Period Ends 7 calendar days after Notice of Intent to Award

1.3 SINGLE POINT OF CONTACT (SPC)

The SPC for this RFP is identified on the Cover Page, along with the SPC’s contact information.

Proposer shall direct all communications related to any provision of the RFP only to the SPC, whether about the technical requirements of the RFP, contractual requirements, the RFP process, or any other provision.

1.4 OREGONBUYS

OregonBuys is the State of Oregon’s procure-to-pay eProcurement solution. All vendors must be registered in OregonBuys to do business with the state. Registration is free. To create a vendor account, click the blue “Register” button in the top right corner of the OregonBuys website:

https://oregonbuys.gov/bso. For registration assistance see vendor registration guidance.

Vendors are responsible for ensuring that their vendor information is current and correct in OregonBuys. Agency will accept no responsibility for incorrect vendor information.

SECTION 2: AUTHORITY, OVERVIEW, AND SCOPE

2.1 AUTHORITY AND METHOD

Agency is issuing this RFP pursuant to its authority under ORS 279A.050 and ORS 731.216.

Agency is using the Competitive Sealed Proposal method, pursuant to ORS 279B.060 and OAR 137-047-0260. Agency may use a combination of the methods for Competitive Sealed Proposals, including optional procedures: a) Competitive Range; b) Discussions and Revised Proposals; c) Revised Rounds of Negotiations; d) Negotiations; e) Best and Final Offers; and f) Multistep Sealed Proposals.

https://oregonbuys.gov/bso

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2.2 DEFINITION OF TERMS

For the purposes of this RFP, capitalized words are defined in OAR 137-046-0110 or as defined below.

2.2.1 General Definitions

The following terms are specific definitions for use in this solicitation and resulting Price Agreement:

• “ACA” means Affordable Care Act.

• “Agency” means the Department of Consumer and Business Services, Division of

Financial Regulation.

• “DCBS” means the Department of Consumer and Business Services, an agency under the

State of Oregon.

• “DFR” means the Division of Financial Regulation. A division under DCBS.

• “Insurer” as defined in ORS 731.106, includes every person licensed by Oregon, engaged in the business of entering into policies of insurance.

• “ORP” means the Oregon Reinsurance Program.

• “WOC” means Work Order Contract.

2.2.2 Crosswalk of Terms used in OregonBuys

• “Amendment” means “Addendum” or “Addenda”, as defined in OAR 137-046-0110(1);

or any form of notice associated with the solicitation, such as intent to award, cancellation, etc., as set forth in the Amendment.

• “Bid Opening” means “Closing” as defined in OAR 137-046-0100(5). In OregonBuys it is the deadline for submitting Quotes (Bids, Offers, Proposals, or other required responses) required by a Bid Solicitation.

• “Bid Solicitation” means any form of opportunity, solicitation or notice: Request for Proposal, Invitation to Bid, Request for Quote, Request for Information, etc., including notices (sole source notice, intent to participate, etc.). Each Bid Solicitation has a separate page and ID number in OregonBuys.

• “Quote” means any form of offer submission by vendors; i.e., Bids, Offers, Proposals, Price Proposals, or any other type of offer required by a Bid Solicitation.

• “Vendor” means any form of business entity registered in OregonBuys.

• “Purchaser” means the single point of contact for this RFP is identified as the

“Purchaser” along with Purchaser’s “Info Contact” (including email address) in OregonBuys.

2.3 OVERVIEW AND PURPOSE

2.3.1 Agency Overview and Background

The Department of Consumer and Business Services (DCBS) is Oregon’s largest regulatory agency. It administers state laws and rules and protects consumers and workers in the areas

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The Division of Financial Regulation (DFR) oversees the financial and insurance industries in Oregon. It regulates insurance, depository institutions, trust companies, drug price transparency board, Oregon’s student loan Ombuds, securities and consumer financial products and services. (e.g., mortgage lending, small dollar loans, collection agencies). The division protects Oregonian’s access to fair products and services through education, regulation and consumer assistance.

As the chartering authority for insurance companies, the Agency’s primary objective is to protect Oregon consumers from market failures that would otherwise cause insurers to incur an excessive risk of insolvency or engage in market abuses that hurt consumers.

The Agency reviews premium rates filed for individual market and small group market health insurance plans, ensuring that rates are reasonable and actuarially sound. The Agency requires Insurer to decrease or increase rates as a necessary to ensure that rates are sufficient, but not excessive.

2.3.2 Project Background and Overview

2.3.2.1 Background

Agency reviews rates filed for individual health insurance plans and small group health insurance plans, ensuring that rates are reasonable and actuarially sound. Agency requires insurers to decrease or increase rates as necessary to ensure that rates are sufficient, but not excessive.

Before the Affordable Care Act (“ACA”), 2013 individual rates increased an average of 7.2 percent and small group rates increased an average 5.9 percent over the previous year.

With implementing the ACA, 2014 set the new baseline for rates as year-over-year rate change comparisons could not be made between pre-ACA and ACA-compliant plans. In 2015, rates increased an average of 5.7 percent for individual and 2.8 percent for small group. However, in 2016, a significant correction, reflecting the actual claims experience, resulted in individual rates increasing an average of 23 percent across all carriers, while small group rates increased an average of less than 1 percent. For 2017, Oregon’s average annual rate increase in the individual market was 27 percent, while small group averaged 4.6 percent increase, reflecting continuing losses in the individual market and the scheduled termination of state and federal risk mitigation programs in December 2016.

To stabilize rates for the individual health plans and small group health plans, Agency applied to the U.S. Department of Health and Human Services (HHS) and U.S.

Department of the Treasury (Treasury for a Patient Protection and Affordable Care Act (PPACA) Section 1332 Waiver. ACA 1332 Waivers are one way HHS and Treasury is providing states with flexibility to establish innovative ways to stabilize the risk pool and meet the needs of their residents. For a waiver to be approved, it has to meet the four guardrails of coverage, comprehensiveness, affordability and deficit neutrality. In July of 2017, Agency’s PPACA 1332 State Relief and Empowerment Waiver (Oregon 1332) was approved to operate the ORP for five years beginning January 1, 2018. Further, Agency

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Insurer fiscal solvency and consumer choice are important Agency concerns. Oregon has six health insurance carriers that offer individual health plans on the Oregon Health Insurance Marketplace. These insurance companies undergo market analysis, rate reviews and audits to ensure they maintain solvency throughout the life of the program.

Recently, 2024 first quarter, recorded an annual enrollment average of over 168,221 members. These enrollment numbers have been leveling out since 2018, due to the strong support of the ORP. Although Oregon continues to have one of the country’s highest number of carriers offering at least 4, and up to 6 individual health plans throughout 36 counties.

Oregon consumers have benefited from federal subsidies, which mitigate or eliminate premium rate increases for those who qualify. Historically premium rates do fluctuate annually, but the Oregon 1332 Waiver has saved consumers between 6.5 percent to 9.2 percent.

2.3.2.2 Overview

The State of Oregon (Oregon) implemented a state-based reinsurance program using a Federal Patient Protection and Affordable Care Act 1332 Waiver (ACA) effective 2018.

State Innovation Waiver's (also referred to as section 1332 waiver) allows states to pursue innovative strategies for providing residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA.

This program is similar to the federal transitional reinsurance program that existed in the early years of the ACA. Moreover, the Oregon Reinsurance Program (ORP) partially reimburses health insurance carriers on the individual insurance marketplace for enrollee's accumulated healthcare claims under eligible ACA individual plans from the Oregon Health Insurance Market Place. The parameters are set annually to help lower premium rates, stabilize the individual health insurance market, and expand coverage throughout the state of Oregon. The parameters consist of a total value of healthcare cost per claimant, measured against a starting attachment point claim amount, below a maximum claim amount, and coinsurance rate. The ORP shares the high cost claims with the Insurer which lessens the burden of the claimant.

2.3.3 Funding

The ORP is funded by grants from the U.S. Department of Health and Human Services and the U.S. Treasury (collectively “Departments”), and a 2% assessment fee is imposed on commercial health premiums. Further, of that 2% assessment fee, 0.3 % is retained by the ORP to reimburse eligible health insurers on the individual health insurance market. The remaining assessment fee of approximately 1.7% is transferred to the Oregon Health Authority to fund Medicaid. As a result, State PPACA 1332 Innovation waivers to help lower the cost of health insurance and expand health insurance plans options throughout the state of Oregon's 36 counties with at least 4 to 6 options per county.

The Departments must determine that the waiver will provide coverage that's at least as comprehensive as the coverage provided without the waiver; provide coverage and cost-https://www.cms.gov/cciio/programs-and-initiatives/state-innovation-waivers/section_1332_state_innovation_waivers-https://healthcare.oregon.gov/Pages/index.aspx https://oregon.public.law/rules/oar_836-150-0040

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DAS PS V4.5_March 31, 2023 Page 8 of 29 sharing protections against excessive out-of-pocket spending that are a least as affordable without the waiver; provide coverage to at least a comparable number of residents as without the waiver; and not increase the federal deficit. This is done by calculating Advanced Premium Tax Credits, member enrollment, federal poverty levels, and comprehensive health plans cost per member. The Departments net savings are passed back to Oregon, to help fund the ORP.

In order to receive the federal funding from the Departments, Agency must apply for an Innovation Waiver under Section 1332 of the Affordable Care Act (ACA) and must be approved. In the event the Innovation Waiver is not approved, Agency anticipates continuing the ORP as approved by Oregon legislature, and funded by Oregon Statute.

2.3.4 Purpose

The Agency is seeking proposals for a qualified Contractor to provide actuarial consulting services to support Agency and policymaker considerations of proposed strategies intended to help stabilize the commercial health insurance markets. Agency is currently drafting proposals to amend the current law with cease dates that match the model of the Federal Oregon 1332 Waiver. Agency anticipates legislative and judicial direction to develop one or more strategies with progress reports required in future legislative sessions and responses to federal regulatory and legislative actions.

Oregon legislature may direct the Agency to pursue strategies not currently under consideration. Agency seeks an actuarial Contractor with the capacity for timely responses to additional requests from the Agency for consultation and advice, beyond those strategies currently identified.

2.4 SCOPE OF WORK/SPECIFICATIONS

The actuarial analysis and consultation services are intended to assist Agency with consideration of proposed strategies and may include the development of additional strategies to help stabilize the commercial health insurance market.

Agency requires the following actuarial services annually:

• Analysis and modeling for the Oregon Reinsurance Program regulatory and enrollment changes.

• Update payment parameters (attachment point, coinsurance rate and cap) for the Oregon Reinsurance Program for contract term in accordance to current state law, and a methodology report outlining the assumptions and methods used.

• Calculate data elements required by the Centers for Medicare & Medicaid Services, Center for Consumer Information and Insurance Oversight for pass-through funding.

Agency anticipates that it may require additional actuarial analyses Services that exceed Agency’s capacity to conduct in-house actuarial staff time or might benefit from access to large, longitudinal national databases that are not available to Agency. The strategies currently identified are:

• Merging individual and small group health plans markets.

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• Reestablishing and expanding a state reinsurance pool for the individual health plan market.

See Attachment A, Sample Price Agreement for further details.

SECTION 3: PROCUREMENT REQUIREMENTS

3.1 MINIMUM QUALIFICATIONS (PASS/FAIL)

To be considered for evaluation, Proposal must demonstrate how Proposer meets all requirements of this section:

3.1.1 Minimum Proposer Requirements

Proposer must meet or exceed the following:

3.1.1.1 Five (5) years’ experience in the last seven (7) years providing health insurance actuarial analyses and reports for consideration by audiences including insurers, elected officials, public administrators, and various stakeholders.

3.1.1.2 Experience in at least two (2) states conducting actuarial analyses used for aspects of Affordable Care Act implementation.

3.1.2 Key Person Requirements

Proposer must employ or contract key person(s) that meet the requirements in this Section. Proposer may submit one or more key person(s) as long as requirements are met.

3.1.2.1 Five (5) years’ experience in the last seven (7) years providing health insurance actuarial analyses and reports for consideration by audiences including insurers, elected officials, public administrators and various stakeholders.

3.1.2.2 Be a fellow or an associate of the Society of Actuaries.

3.1.2.3 Be a member in good standing of one or more of the following:

• The Society of Actuaries

• The American Academy of Actuaries

3.2 MINIMUM SUBMISSION REQUIREMENTS (PASS/FAIL)

3.2.1 Proposal Submissions

To be considered for evaluation, Proposal must contain each of the following elements further detailed in Proposal Requirements Section 3.3 below:

Mandatory:

• Executive Summary

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• Administrative Proposal

• Key Persons and Resumes

• Technical Proposal

• Price Proposal Form (Attachment E)

• Proposer Information and Certification Sheet (Attachment C)

• Reference Check Form (Attachment D)

• COBID Certification / Outreach Plan (Attachment F)

• Responsibility Inquiry (Attachment G)

Optional:

• Disclosure Exemption Affidavit (Attachment B)

• Redacted Proposal

Proposer Note: Disclosure Exemption Affidavit (Attachment B) is required only if any part of Proposal is exempt from disclosure under Oregon Public Records Law. See Section 3.3.7 for further details.

3.2.2 Proposal Page Limits

There is no page limit for this Proposal.

3.2.3 Proposal Format and Quantity

Proposal should follow the format and reference the sections listed in the Proposal Requirements Section 3.3. Responses to each section and subsection should be labeled to indicate the item being addressed.

Proposer should submit its Proposal electronically through OregonBuys. Proposer should follow the procedures outlined in Section 4.5 for electronic submission.

The Price Proposal, Attachment E, must be submitted as a separate electronic response file.

3.2.4 Authorized Representative

A representative authorized to bind the Proposer must sign the Proposal. Failure of Proposer’s authorized representative to sign the Proposal may result in rejection of the Proposal by Agency.

3.3 PROPOSAL REQUIREMENTS

Proposal must address each of the items listed in this section and all other requirements set forth in this RFP. Proposer must describe the Goods to be provided or the Services to be performed or both. A Proposal that merely offers to provide the goods or services as stated in this RFP may be considered non-Responsive to this RFP and will not be considered further.

Proposal should not include extensive artwork, unusual printing or other materials not essential

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3.3.1 Executive Summary (Mandatory, Scored)

Proposals must include an executive summary, no more than two (2) pages, which condenses and highlights the contents of the Proposal, including an overview of the Proposer's understanding of the contents of the RFP, and a description of how the Proposer generally intends to meet the RFP requirements.

The Executive Summary will be evaluated as per section 4.10.2.

3.3.2 Administrative Proposal (Mandatory, Scored)

The Administrative Proposal must document in detail how the Proposer meets the minimum proposer requirements noted in section 3.1. It must describe in detail Proposer’s experience with individual and small group health plans, Medicaid and reinsurance pools as related to the requested services.

The Administrative Proposal will be evaluated as per section 4.10.2.

3.3.3 Key Persons (Mandatory, Scored)

Specify Key Persons to be assigned to this project and include a current resume (not to exceed two pages each) for each individual that demonstrates qualifications and experience for the Services described in this RFP. Proposer must document in detail how the Key Person(s) meets the minimum requirements of Section 3.1.2.

Key Persons will be evaluated as per section 4.10.2.

3.3.4 Key Persons Exhibit (Mandatory, Not Scored)

Proposer shall complete and submit the Key Persons Exhibit (Attachment H). Proposer shall list Key People responsible for assuring the Services provided under the Price Agreement are performed in descending order, starting with the key person with the highest qualifications, number one (1) Key Person and so forth.

3.3.5 Technical Proposal (Mandatory, Scored)

Provide a comprehensive management plan that the Proposer intends to follow, including procedures to meet the requirements of section 2.4, Scope of Work/Specifications. Describe how Proposer would calculate the assumptions outlined within relation to the context of the Scope of Work. Illustrate how the plan will serve to coordinate and accomplish the work, including but not limited to meeting the requirements of the Services. Describe how the management plan will serve to coordinate and facilitate successful delivery of the Services.

Describe major implementation milestones, timing, and strategy to meet deliverable requirements. Describe your access to federal clearinghouses, exchanges, federal EDGE servers, and State and local data resources.

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The Technical Proposal will be evaluated as per section 4.10.2.

3.3.6 Price Proposal (Mandatory, Scored)

Agency is electing not to have quotes entered in OregonBuys on the items tab directly.

For OregonBuys purposes only, when completing the quote process on the items tab, enter a cost of $1.00.

Proposer must submit one (1) original Price Proposal, Attachment E. It must be submitted as a separate document from the remainder of the Proposal. Pricing should only be included in this Price Proposal, and no other Proposal sections.

Price Proposal should include the hourly rates for all key person positions and all positions necessary to perform the requested Services. Price Proposal should be inclusive of all related costs necessary to perform the requested Services, excluding any travel related expenses. Agency does not anticipate any travel expenses associated with these Services. If travel becomes necessary, reimbursement will be separately agreed to in WOCs.

Price Proposals shall be firm for a period of 180 days from the Bid Opening of the RFP.

If Agency requires clarification of any pricing information included in the Proposer’s Price Proposal, Proposer shall provide clarification within two (2) business days (Monday – Friday, state observed holidays excluded) or the Proposal may be rejected as non-responsive at the sole discretion of the Agency.

The Price Proposal will be evaluated as per section 4.10.6.

3.3.7 Disclosure Exemption Affidavit (Optional, Not Scored)

All Proposals are public record and are subject to public inspection after Agency issues the Notice of the Intent to Award. Attachment B is required only if Proposer believes any of its Proposal is exempt from disclosure under Oregon Public Records Law (ORS 192.311 through 192.478).

If Proposer believes any of the Proposal is exempt from public disclosure:

• Proposer must complete and submit the Disclosure Exemption Affidavit, Attachment B.

• Proposer must submit a fully redacted version of its Proposal, clearly identified as the redacted version. This is in addition to submitting a non-redacted Proposal.

• Proposer must mark as “Confidential” on all OregonBuys attachments Proposer believes are exempt from public disclosure.

Proposer is cautioned that cost information generally is not considered a trade secret under Oregon Public Records Law and identifying the Proposal, in whole, as exempt from disclosure is not acceptable. Agency advises each Proposer to consult with its own legal counsel regarding disclosure issues.

If Proposer fails to identify the portions of the Proposal that Proposer claims are exempt from disclosure, Proposer has waived any future claim of non-disclosure of that information.

3.3.8 Proposer Information and Certification Sheet (Mandatory, Not Scored)

Proposer shall complete and submit the Proposer Information and Certification Sheet

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(Attachment C). The Proposer Information and Certification Sheet must bear the Proposer’s authorized representative’s Signature.

Failure to demonstrate compliance with Oregon Tax Laws and sign the Proposer Information and Certification Sheet may result in a finding of non-Responsibility.

3.3.9 References (Mandatory, Scored)

Proposer shall provide three (3) references on the provided Reference Check Form (Attachment D), from current or former client firms for similar projects performed within the last five (5) years. References must be able to verify the quality of previous, related Work.

Agency may check to determine if references provided support Proposer’s ability to comply with the requirements of this RFP. Agency may use references to obtain additional information, or verify any information needed. Agency may contact any reference (submitted or not) to verify Proposer’s qualifications.

Proposer shall submit the Reference Check Form (Attachment D) with reference names and contact information. Agency will make three (3) attempts to contact each of the references provided by the Proposer. If these attempts are unsuccessful, the Proposer will receive a score of zero (0) for that reference.

References will be evaluated as per section 4.10.5.

Proposer Note: Three (3) references are required. If the Proposer submits more than three

(3) references, only the first three (3) references will be used.

3.3.10 Certified Disadvantaged Business Outreach Plan (Mandatory, Not Scored)

Proposer shall complete and submit the Certified Disadvantaged Business Outreach Plan (Attachment F). See section 6.2 for further details.

Proposer may mark the sections as “Not Applicable (N/A)” if appropriate when submitting.

3.3.11 Proposer Responsibility Inquiry (Mandatory, Not Scored)

Proposer shall complete and submit the Proposer Responsibility Inquiry (Attachment G).

See section 4.10.1.2 for further details.

SECTION 4: SOLICITATION PROCESS

4.1 PUBLIC NOTICE

The RFP and attachments are published in the State of Oregon’s electronic procurement system OregonBuys at https://oregonbuys.gov/. Solicitation documents will not be mailed to prospective Proposers.

Modifications, if any, to this RFP will be made by written Amendment(s) published in OregonBuys. Prospective Proposer is solely responsible for checking OregonBuys to determine whether or not any Amendment(s) have been issued. Amendment(s) are incorporated into the https://oregonbuys.gov/

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RFP by this reference.

In addition, Agency reserves the right to post information about this RFP on their website, Department of Consumer and Business Services under News & Information. Solicitation documents are not available through the DCBS website.

4.2 PRE-PROPOSAL CONFERENCE

A Pre-Proposal conference will not be held for this RFP.

4.3 QUESTIONS / REQUESTS FOR CLARIFICATIONS

All inquiries, whether relating to the RFP process, administration, deadline or method of award, or to the intent or technical aspects of the RFP must:

• Be emailed to the SPC;

• Reference the OregonBuys bid number;

• Identify Proposer’s name and contact information;

• Refer to the specific area of the RFP being questioned (i.e. page, section and paragraph number); and

• Be received by the due date and time for Questions/Requests for Clarification identified in the Schedule in Section 1.2.

4.4 SOLICITATION PROTESTS

4.4.1 Protests to RFP

Prospective Proposer may submit a Written protest of anything contained in this RFP, including but not limited to, the RFP process, Specifications, Scope of Work, and the proposed Sample Price Agreement. This is prospective Proposer’s only opportunity to protest the provisions of the RFP, except that Proposer may protest Amendment(s) as provided below and Proposer may take exception to the terms and conditions of the Sample Price Agreement marked as negotiable as set forth in the Negotiations Section.

4.4.2 Protests to Amendment(s)

Prospective Proposer may submit a Written protest of anything contained in an Amendment. Protests to an Amendment, if issued, must be submitted by 5:00 p.m. Pacific Time on the second Business Day following the issuance of the Amendment or the date/time specified in the Amendment, or they will not be considered. Protests of matters not added or modified by the Amendment will not be considered.

4.4.3 Requirements for Protests

All protests must:

• Be emailed to the SPC;

• Reference the OregonBuys bid number;

https://www.oregon.gov/DCBS/Pages/index.aspx

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• Identify prospective Proposer’s name and contact information;

• Be sent by an authorized representative;

• State the reason for the protest, including:

o the grounds that demonstrate how the Procurement Process is contrary to law, Unnecessarily Restrictive, legally flawed, or improperly specifies a brand name;

and o evidence or documentation that supports the grounds on which the protest is based; and

• State the proposed changes to the RFP provisions or other relief sought.

Protests to the RFP must be received by the due date and time identified in the Schedule.

Protests to an Amendment must be received by the due date identified in the Amendment.

4.5 PROPOSAL DELIVERY OPTIONS

Proposer is solely responsible for ensuring its Proposal is received by the SPC in accordance with the RFP requirements before Bid Opening. Agency is not responsible for any delays in mail or by common carriers or by transmission errors or delays, or for any mis-delivery for any reason. A Proposal submitted by any means not authorized below will be rejected. The following delivery options are permitted for this RFP:

4.5.1 Delivery through OregonBuys

Proposal submission should be electronically through OregonBuys at OregonBuys.gov.

Detailed instructions on how to submit a Proposal can be found at OregonBuys Vendor Formal Solicitation Response.pdf

The Price Proposal must be submitted as a separate electronic response file.

Proposer shall submit one original copy of its Proposal and all other submission requirements. Documents must be submitted using one of the following formats: Adobe Acrobat (pdf), Microsoft Word (docx), or Microsoft Excel (xlsx), following the layout indicated in Section 3.3, Proposal Requirements. Responses to each section and subsection should be labeled to indicate the item being addressed.

Submissions can be a pdf, zip file, etc., but there should only be a total of three or four separate attachments. Label each attachment and include the appropriate documents in each attachment as indicated below.

• Submission 1: Proposal - Sections 3.2.1 through 3.2.4

• Submission 2: Price Proposal - Section 3.3.6

• Submission 3: Attachments Group - Sections 3.3.1 through 3.3.11

• Submission 4: Redacted Proposal - Section 3.3.7, if applicable

Agency requests that you do not password protect your original submissions or provide an additional copy of your submissions that are not password protected. Please contact the SPC https://oregonbuys.gov/bso/view/login/login.xhtml https://www.oregon.gov/das/ORBuys/Documents/OregonBuys%20Vendor%20Formal%20Solicitation%20Response.pdf https://www.oregon.gov/das/ORBuys/Documents/OregonBuys%20Vendor%20Formal%20Solicitation%20Response.pdf

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Failure to demonstrate compliance with these submission requirements may result in a finding of non-Responsiveness.

4.6 PROPOSAL MODIFICATION OR WITHDRAWAL

If a Proposer wishes to make modifications to a submitted Proposal, the Proposer must submit its modification in one of the authorized methods listed in Section 4.5 (Proposal Delivery Options). To be effective the modification must include the OregonBuys bid number and be submitted to the SPC prior to Bid Opening.

If a Proposer wishes to withdraw a submitted Proposal, it must submit a Written notice signed by an authorized representative of its intent to withdraw to the SPC via email prior to the Bid Opening in accordance with OAR 137-047-0440. To be effective, the notice must include the OregonBuys bid number.

4.7 PROPOSAL DUE

A Proposal (including all required submittal items) must be received by the SPC on or before Bid Opening. All Proposal modifications or withdrawals must also be received prior to Bid Opening.

A Proposal received after Bid Opening is considered LATE and will NOT be accepted for evaluation. A late Proposal will be returned to the Proposer or destroyed.

4.8 PUBLIC OPENING

There will be no public Opening of Proposals. Proposals received will not be available for inspection until after the evaluation process has been completed and the Notice of Intent to Award is issued. However, Agency will record and make available the identity of all Proposers after Opening. This information will be made available as an amendment to the solicitation in OregonBuys.

4.9 PROPOSAL REJECTION

Agency may reject a Proposal for any of the following reasons:

• Proposer fails to substantially comply with all prescribed RFP procedures and requirements, including but not limited to the requirement that Proposer’s authorized representative sign the Proposal.

• Proposer has liquidated and delinquent debt owed to the State or any department or agency of the State.

• Proposer fails to meet the responsibility requirements of ORS 279B.110.

• Proposer makes any contact regarding this RFP with State representatives such as State employees or officials other than the SPC or persons authorized by the SPC, or inappropriate contact with the SPC.

• Proposer attempts to influence a member of the Evaluation Committee.

• Proposal is conditioned on Agency’s acceptance of any other terms and conditions or rights

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4.10 EVALUATION PROCESS

4.10.1 Responsiveness and Responsibility Determination

4.10.1.1 Responsiveness determination

A Proposal received prior to Bid Opening will be reviewed to determine if it is Responsive to all RFP requirements including compliance with Section 3.1 (Minimum Qualifications) and Section 3.2 (Minimum Submission Requirements). If the Proposal is unclear, the SPC may request clarification from Proposer. However, clarifications may not be used to rehabilitate a non-Responsive proposal. If the SPC finds the Proposal non- Responsive, the Proposal may be rejected; however, Agency may waive mistakes in accordance with OAR 137-047-0470.

4.10.1.2 Responsibility Determination

Agency will determine if an apparent successful Proposer is Responsible prior to award and execution of the Price Agreement. Proposers shall submit a signed Responsibility Inquiry form (Attachment G) with Proposal.

At any time prior to award, Agency may reject a Proposer found to be not Responsible.

4.10.2 Proposal Evaluation Criteria

Proposals received on time and meeting all Responsiveness requirements will be independently evaluated by members of an Evaluation Committee. Evaluation Committee members may change and Agency may have additional or fewer evaluators for optional rounds of competition. The Evaluation Committee will evaluate Proposals in accordance with the evaluation procedures set forth in OAR 137-047-0600 through 137-047-670, ORS 279A and ORS 279B.

SPC may request further clarification to assist the Evaluation Committee in gaining additional understanding of a Proposal. A response to a clarification request may only clarify or explain portions of the already submitted Proposal and may not contain new information not included in the original Proposal.

4.10.2.1 Executive Summary, Section 3.3.1 (50 Points)

(A) How well did Proposer demonstrate a clear understanding of the Scope of Work and the services requested in this RFP? (25 Points)

(B) How well did Proposer describe how they generally intend to meet the RFP requirements? (25 Points)

4.10.2.2 Administrative Proposal, Section 3.3.2 (225 Points)

(A) How well did Proposer describe their experience, skills and knowledge providing this type of service? (100 Points)

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(B) How well does Proposer’s staff qualifications and experience, including key person(s), providing these services? (75 Points)

(C) How well did the Proposer’s Administrative Proposal capture the overall intent of requested services? (50 Points)

4.10.2.3 Key Persons, Section 3.3.3 (250 Points)

(A) How well do the qualifications of the Key Persons reflect the requirements of the outlined Scope of Work? (75 Points)

(B) The degree to which Key Persons have experience in the skill areas required to perform the services request in the Scope of Work? (75Points)

(C) Does each Key Person meet the minimum requirements outlined in Section 3.1.2?

(100 Points)

4.10.2.4 Technical Proposal, Section 3.3.5 (450 Points)

(A) How well did Proposer provide a comprehensive management plan to carry out the activities of these services in context with the Scope of Work? (75 Points)

(B) How well did Proposer‘s management plan align with the requirements of the RFP to meet the needs of the Agency? (75 Points)

(C) How well does the Proposer describe resources, tools or access to data, in addition to State and Federal sourced data, that could support these services?

(150 Points)

(D) Does the Proposer’s experience provide evidence of their capacity to produce high quality products that will be useful for Agency, policymakers, and stakeholders to sort and prioritize strategies? (150 Points)

4.10.2.5 Overall Proposal (40 Points)

(A) Was information easy to find and labeled appropriately? (20 Points)

(B) Did Proposal include any unsolicited marketing or advertising material? (20 Points)

4.10.3 Score Calculations

Evaluators will assign a score based on the evaluation rating scale indicated below for each evaluation criterion listed in Section 4.10.2 and 4.10.4.

Scores are the values (0 through 100) assigned by each evaluator.

Evaluation Committee Member’s evaluation (scores) of a Proposal; in light of the criteria described in sections 3.3 and 4.10, is based on the following explanations:

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Evaluation Rating Scale for each evaluation criteria listed in Section 4.10.2 & 4.10.4

Relative Score Scale EXPLANATION

81% – 100%

OUTSTANDING - Response meets all requirements and has demonstrated in a clear and concise manner a thorough knowledge and understanding of the subject matter and project. The Proposer provides insight into its expertise, knowledge, and understanding of the subject matter.

61% – 80%

VERY GOOD – Response demonstrates above average knowledge and ability with no apparent deficiencies noted. Response provides useful information, while showing experience and knowledge within the category.

41% – 60%

ADEQUATE – Response meets all requirements in an adequate/average manner. Response demonstrates an ability to comply with guidelines, parameters, and requirements with no additional information put forth by the Proposer.

21% – 40% FAIR – Proposer meets minimum requirements in a below average manner and does not demonstrate sufficient knowledge of the subject matter.

0% – 20% RESPONSE OF LITTLE TO NO VALUE – An unacceptable response that does not meet some or all the requirements set forth in the RFP.

Proposer has not demonstrated knowledge of the subject matter.

4.10.4 Point Calculations

Points are the total possible for each evaluation section as listed in the table below.

TOTAL POINTS POSSIBLE: 1075

RFP

Section

4.10.2.1 Executive Summary Points Possible

(A) How well did Proposer demonstrate a clear understanding of the Scope of Work and the services requested in this RFP? 50

(B) How well did Proposer describe how they generally intend to meet the RFP requirements? 50

4.10.2.2 Administrative Proposal Points Possible

(A) How well did Proposer describe their experience, skills and knowledge providing this type of service?

(B) How well does Proposer’s staff qualifications and experience, including 75

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Points are calculated as follows:

Evaluators will evaluate each Proposal and assign a score, 0 – 100 per evaluation criterion as per the rating scale in section 4.10.3. For point calculation purposes, the evaluation scores are entered as a percentage (i.e., an evaluation score of 75 is calculated as 75%).

Example:

Proposer A receives an evaluation score of 75 (0 – 100) for a criterion worth 50 points. 75% (score) is multiplied by 50 (points possible) for 38 points out of the possible 50 points (rounded up or down for whole numbers only) for that evaluation criterion. This method is used for each evaluation criterion, per evaluator.

The SPC will total the points for each evaluation criterion by Evaluator. The average of all the evaluator’s total points will be the Proposer’s Points. This is calculated by dividing the total points, by the number of evaluators.

Example:

The points possible for the technical proposal is 150. There are 3 evaluators. Proposer A key person(s), providing these services.

(C) How well did the Proposer’s Administrative Proposal capture the overall intent of requested services?

4.10.2.3 Key Persons Points Possible

(A) How well do the qualifications of the Key Persons reflect the requirements of the outlined Scope of Work?

(B) The degree to which Key Persons have experience in the skill areas required to perform the services request in the Scope of Work?

(C) Does each Key Person meet the minimum requirements outlined in Section 3.1.2?

4.10.2.4 Technical Proposal Points Possible

(A) How well did Proposer provide a comprehensive management plan to carry out the activities of these services in context with the Scope of Work?

(B) How well did Proposer‘s management plan align with the requirements of the RFP to meet the needs of the Agency?

(C) How well does the Proposer describe resources, tools or access to data, in addition to State and Federal sourced data, that could support these services?

(D) Does the Proposer’s experience provide evidence of their capacity to produce high quality products that will be useful for Agency, policymakers, and stakeholders to sort and prioritize strategies?

4.10.2.5 Overall Proposal Points Possible

(A) Was information easy to find and labeled appropriately? 20

(B) Did Proposal include any unsolicited marketing or advertising material? 20

4.10.5 Reference Points Possible 30

4.10.6 Price Points Possible 30

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4.10.5 References, Section 3.3.9 (30 Points)

Proposer shall provide references that can describe Proposer’s performance to following questions:

(A) Describe your experience with Proposer’s completion or delivery of services on schedule.

(B) Describe your experience with Proposer’s accuracy of actuarial work performed with individual and small group health plans, Medicaid and reinsurance pools.

(C) Describe your experience with Proposer’s specifications and contractual obligations.

(D) Describe your experience with Proposer’s clarity of work product and communications.

(E) How likely would you be to use Proposer’s services again? Please explain.

Proposer shall complete and submit reference names and contact information (Attachment D). Proposer is responsible to ensure information provided is accurate and relevant to these requested services. Agency assumes no responsibility for incorrect contact information.

Agency will make three (3) attempts to contact each of the references provided by Proposer.

If these attempts are unsuccessful, Proposer will receive a score of zero for that reference.

The evaluation committee will evaluate the Proposer on the reference responses. Evaluators will assign one total score value for the combined references and responses on a scale of 0 to 100, using the evaluation scale rating in Section 4.10.3. Scores will be multiplied by the point value. The points awarded will be the average of the reference scores. If applicable, SPC will deduct 33% from each score, per evaluator, for each unsuccessful reference attempt.

Example:

References have a point value of 30. Proposer A receives references scores of 85, 75, and 100 from the three evaluators. For point calculation purposes, the evaluation scores are entered as a percentage (i.e., an evaluation score of 75 is calculated as 75%).

Each score is multiplied by 30 (points possible) to calculate the points per evaluator. The points awarded will be the average of the reference scores/points.