RFP Update 10.22.26.pdf

i SPB Form 22 | RFP Template | Effective 07012025

State of Nebraska (Department of Health and Human Services)

REQUEST FOR PROPOSAL FOR SERVICES CONTRACT

SOLICITATION NUMBER RELEASE DATE

125920 O3 September 3, 2026

OPENING DATE AND TIME PROCUREMENT CONTACT

October 21, 2026, 2:00 p.m. Central Time Angellica Shasteen

PLEASE READ CAREFULLY!

SCOPE OF SERVICE

The State of Nebraska (State), Department of Health and Human Services (DHHS), is issuing this solicitation for a service contract for the purpose of selecting a qualified bidder to provide a Nebraska Medicaid Enrollment Broker. A more detailed description can be found in Section I. The resulting contract may not be an exclusive contract as the State reserves the right to contract for the same or similar services from other sources now or in the future.

The term of the contract will be five (5) years commencing upon execution of the contract by DHHS and the Vendor. The Contract includes the option to renew for (one) additional three-year period upon mutual agreement of the Parties. DHHS reserves the right to extend the period of this contract beyond the termination date when mutually agreeable to the Parties.

In the event that a contract with the awarded bidder(s) is cancelled or in the event that DHHS needs additional Vendors to supply the solicited services, this solicitation may be used to procure the solicited services for up to eighteen (18) months from the date the Intent to Award is posted, provided that 1) the solicited goods or services will be provided by a bidder (or a successive owner) who submitted a response pursuant to this solicitation, 2) the bidder’s solicitation response was evaluated, and 3) the bidder will honor the bidder’s original solicitation response, including the proposed cost, allowing for any price increases that would have otherwise been allowed if the bidder would have received the initial award.

ALL INFORMATION PERTINENT TO THIS SOLICITATION CAN BE FOUND ON THE INTERNET AT:

https://das.nebraska.gov/materiel/bidopps.html.

A mandatory Solicitation Conference will be held on October 14, 2026 at on Webex, link in the Schedule of Events.

IMPORTANT NOTICE: Pursuant to Neb. Rev. Stat. § 84-602.04, State contracts in effect as of January 1, 2014, and contracts entered into thereafter, must be posted to a public website. The resulting contract, the Solicitation, and the awarded solicitation response will be posted to a public website managed by DAS, which can be found at http://statecontracts.nebraska.gov and https://www.nebraska.gov/das/materiel/purchasing/contract_search/index.php.

In addition and in furtherance of the State’s public records Statute (Neb. Rev. Stat. § 84-712 et seq.), all responses received regarding this Solicitation will be posted to the Department of Health and Human Services public website.

These postings will include the entire solicitation response. Bidder must request that proprietary information be excluded from the posting.

The bidder must identify the proprietary information, mark the proprietary information according to state law, and submit the proprietary information in a separate file named conspicuously as "PROPRIETARY INFORMATION". The bidder should submit a detailed written document showing that the release of the proprietary information would give a business advantage to named business competitor(s) and explain how the named business competitor(s) will gain an actual business advantage by disclosure of information. The mere assertion that information is proprietary or that a speculative business advantage might be gained is not sufficient. (See Attorney General Opinion No. 92068, April 27, 1992). THE BIDDER MAY NOT ASSERT THAT THE ENTIRE SOLICITATION IS PROPRIETARY. COST SHEETS WILL NOT BE CONSIDERED PROPRIETARY AND ARE A PUBLIC RECORD IN THE STATE OF NEBRASKA. The State will determine, in its sole discretion, if the disclosure of the information designated by the Bidder as proprietary would 1) give advantage to business competitors and 2) serve no public purpose. The Bidder will be notified of the State’s decision. Absent a determination by the State that the information may be withheld pursuant to Neb. Rev. Stat. § 84-712.05, the State will consider all information a public record subject to disclosure.

If the State determines it is required to release withheld proprietary information, the bidder will be informed. It will be the bidder's responsibility to defend the bidder's asserted interest in non-disclosure.

To facilitate such public postings, with the exception of proprietary information, the State of Nebraska reserves a royalty-free, nonexclusive, and irrevocable right to copy, reproduce, publish, post to a website, or otherwise use any contract, or solicitation response for any purpose, and to authorize others to use the documents. Any individual or entity awarded a contract, or who submits a solicitation response, specifically waives any copyright or other protection the contract, or solicitation response may have; and acknowledges that they have the ability and authority to enter into such waiver. This reservation and waiver are a prerequisite for submitting a solicitation response, and award of a contract. Failure to agree to the reservation and waiver will result in the solicitation response being found non-responsive and rejected.

https://das.nebraska.gov/materiel/bidopps.html http://statecontracts.nebraska.gov/ https://www.nebraska.gov/das/materiel/purchasing/contract_search/index.php ii SPB Form 22 | RFP Template | Effective 07012025

Any entity awarded a contract or submitting a solicitation response agrees not to sue, file a claim, or make a demand of any kind, and will indemnify and hold harmless the State and its employees, volunteers, agents, and its elected and appointed officials from and against any and all claims, liens, demands, damages, liability, actions, causes of action, losses, judgments, costs, and expenses of every nature, including investigation costs and expenses, settlement costs, and attorney fees and expenses, sustained or asserted against the State, arising out of, resulting from, or attributable to the posting of the contract or solicitation response, awards, and other documents.

TABLE OF CONTENTS

REQUEST FOR PROPOSAL FOR SERVICES CONTRACT ....................................................................................................i

GLOSSARY OF TERMS ...........................................................................................................................................................v

ACRONYM LIST ......................................................................................................................................................................xi

I. PROCUREMENT PROCEDURE

A. GENERAL INFORMATION

B. PROCURING OFFICE AND COMMUNICATION WITH STATE STAFF AND EVALUATORS

C. SCHEDULE OF EVENTS

D. WRITTEN QUESTIONS AND ANSWERS

E. SOLICITATION CONFERENCE

F. NOTICE OF INTENT TO ATTEND MANDATORY SOLICITATION CONFERENCE

G. SECRETARY OF STATE/TAX COMMISSIONER REGISTRATION REQUIREMENTS (Nonnegotiable)

H. ETHICS IN PUBLIC CONTRACTING

I. DEVIATIONS FROM THE SOLICITATION

J. SUBMISSION OF SOLICITATION RESPONSES

K. SOLICITATION PREPARATION COSTS

L. FAILURE TO COMPLY WITH SOLICITATION

M. SOLICITATION RESPONSE CORRECTIONS

N. LATE SOLICITATION RESPONSES

O. BID OPENING

P. SOLICITATION REQUIREMENTS

Q. EVALUATION COMMITTEE

R. EVALUATION OF SOLICITATION RESPONSES

S. BEST AND FINAL OFFER

T. REFERENCE AND CREDIT CHECKS

U. AWARD

V. LUMP SUM OR “ALL OR NONE” SOLICITATION RESPONSES

W. REJECTION OF SOLICITATION RESPONSES

X. PRICES & COST CLARIFICATION

Y. VENDOR DEMONSTRATIONS

II. TERMS AND CONDITIONS

A. GENERAL

B. NOTIFICATION

C. BUYER’S REPRESENTATIVE

D. GOVERNING LAW (Nonnegotiable)

E. BEGINNING OF WORK & SUSPENSION OF SERVICES

F. AMENDMENT

G. CHANGE ORDERS OR SUBSTITUTIONS

H. RECORD OF VENDOR PERFORMANCE

I. NOTICE OF POTENTIAL VENDOR BREACH

J. BREACH

K. NON-WAIVER OF BREACH

L. SEVERABILITY

M. INDEMNIFICATION

N. ATTORNEY'S FEES

O. PERFORMANCE BOND

P. ASSIGNMENT, SALE, OR MERGER

iii SPB Form 22 | RFP Template | Effective 07012025

Q. CONTRACTING WITH OTHER NEBRASKA POLITICAL SUBDIVISIONS OF THE STATE OR ANOTHER

STATE

R. FORCE MAJEURE

S. COMPLIANCE WITH PRESIDENTIAL EXECUTIVE ORDERS 14151 AND 14173

T. CONFIDENTIALITY

U. EARLY TERMINATION

V. CONTRACT CLOSEOUT

W. AMERICANS WITH DISABILITIES ACT

X. LONG-TERM CARE OMBUDSMAN (Nonnegotiable) Y. OFFICE OF PUBLIC COUNSEL (Nonnegotiable)

Z. LOBBYING

AA. LIQUIDATED DAMAGES/PERFORMANCE PENALTIES

III. VENDOR DUTIES

A. INDEPENDENT VENDOR / OBLIGATIONS

B. FOREIGN ADVERSARY CONTRACTING PROHIBITION ACT CERTIFICATION (Nonnegotiable)

C. EMPLOYEE WORK ELIGIBILITY STATUS

D. COMPLIANCE WITH CIVIL RIGHTS LAWS AND EQUAL OPPORTUNITY EMPLOYMENT /

NONDISCRIMINATION (Nonnegotiable)

E. COOPERATION WITH OTHER VENDORS

F. DISCOUNTS

G. PRICES

H. PERMITS, REGULATIONS, LAWS

I. OWNERSHIP OF INFORMATION AND DATA / DELIVERABLES

J. INSURANCE REQUIREMENTS

K. ANTITRUST

L. CONFLICT OF INTEREST

M. ADVERTISING

N. NEBRASKA TECHNOLOGY ACCESS STANDARDS (Nonnegotiable)

O. DISASTER RECOVERY/BACK UP PLAN

P. DRUG POLICY

Q. WARRANTY

R. TIME IS OF THE ESSENCE

S. DHHS HIPAA BUSINESS ASSOCIATE PROVISIONS

IV. PAYMENT

A. PROHIBITION AGAINST ADVANCE PAYMENT (Nonnegotiable) B. TAXES (Nonnegotiable)

C. INVOICES

D. INSPECTION AND APPROVAL

E. PAYMENT (Nonnegotiable) F. LATE PAYMENT (Nonnegotiable) G. SUBJECT TO FUNDING / FUNDING OUT CLAUSE FOR LOSS OF APPROPRIATIONS (Nonnegotiable)

H. RIGHT TO AUDIT (First Paragraph is Nonnegotiable)

V. PROJECT DESCRIPTION AND SCOPE OF WORK

A. PURPOSE OF THIS SOLICITATION

B. SCOPE OF WORK

C. PROGRAM DESCRIPTION

D. ENROLLMENT BROKER RESPONSIBILITIES

E. ORGANIZATIONAL REQUIREMENTS

F. STAFFING REQUIREMENTS

G. QA AND PERFORMANCE MEASURES

H. GRIEVANCES

I. PROGRAM INTEGRITY

iv SPB Form 22 | RFP Template | Effective 07012025

J. FUNCTIONAL REQUIREMENTS

K. WORK PRODUCT REVIEW PROCESS

L. ADDITIONAL REPORTING REQUIREMENTS

M. CONTRACT MONITORING

N. PENALTIES AND SANCTIONS

O. TRANSITION AND IMPLEMENTATION

P. TURNOVER PHASE OF CONTRACT

Q. TECHNICAL RESPONSE

R. COST PROPOSAL REQUIREMENTS

S. COST PROPOSAL INSTRUCTIONS

T. CMS CERTIFICATION REQUIREMENTS

VI. SOLICITATION RESPONSE INSTRUCTIONS

A. SOLICITATION RESPONSE SUBMISSION

CONTRACTUAL AGREEMENT FORM

INTENT TO ATTEND SOLICITATION CONFERENCE

v SPB Form 22 | RFP Template | Effective 07012025

GLOSSARY OF TERMS

Acceptance Test Procedure: Benchmarks and other performance criteria, developed by the State or other sources of testing standards, for measuring the effectiveness of products or goods and the means used for testing such performance

Act: Social Security Act

Addendum: A written correction or alteration to a document during the solicitation process (e.g., Questions and Answers, Revised Schedule of Events, Addendum to Contract Award)

Agency: All officers of the State, departments, bureaus, boards, commissions, councils, and institutions receiving legislative appropriations

Agent/Representative: A person authorized to act on behalf of another

Amend: To alter or change by adding, subtracting, or substituting

Amendment: A written correction or alteration to a document

Appeal: A request for review of action

Applicant: An individual who has applied for coverage under Title XIX or Title XXI of the Social Security Act, but has not yet been determined eligible

Appropriation: Legislative authorization to expend public funds for a specific purpose; money set apart for a specific use

Auto Assignment: The process by which an enrollee, who does not select an MCO or PCP/PCD within a predetermined length of time during enrollment, is automatically assigned to an MCO or PCP/PCD

Automated Clearing House (ACH): Electronic network for financial transactions in the United States

Award: All purchases, leases, or contracts which are based on competitive solicitations will be awarded according to the provisions in the solicitation

Best and Final Offer (BAFO): In a competitive solicitation, the final offer submitted which contains Vendor’s most favorable terms for price

Bid: See Solicitation Response

Bid/Proposal: The offer submitted by a vendor in response to a written solicitation

Bid Bond: An insurance agreement, accompanied by a monetary commitment, by which a third party (the surety) accepts liability and guarantees that the vendor will not withdraw the bid

Bid Opening: The process of opening correctly submitted solicitation responses at the time and place specified in the written solicitation and in the presence of any bidder who wishes to attend

Bidder: A Vendor who submits a Solicitation Response

Breach: Violation of a contractual obligation by failing to perform or repudiation of one’s own promise

Business: Any corporation, partnership, individual, sole proprietorship, joint-stock company, joint venture, or any other private legal entity

Business Day: Any weekday, except State-recognized holidays

Calendar Day: Every day shown on the calendar including Saturdays, Sundays, and State/Federal holidays

Cancellation: To call off or revoke a solicitation, purchase order, or contract without expectation of conducting or performing at a later time

Captivation Payment: A monthly payment by the State to an MCO on behalf of each member of an MCO for the provision of covered services under the contract. Payment is made regardless of whether any particular member receives services during the period covering the payment vi SPB Form 22 | RFP Template | Effective 07012025

Catalog/Non-Core: A printed or electronic list of products a Vendor may provide at a discounted rate or discount off list price to the State. Initial contract award(s) is not based on Catalog/Non-Core items

Central Processing Unit (CPU): Any computer or computer system that is used by the State to store, process, or retrieve data or perform other functions using Operating Systems and applications software

Change Order: Document that provides amendments to an executed purchase order or contract

Children’s Health Insurance Program (CHIP): Nebraska has a combination Medicaid CHIP program. Its Medicaid CHIP expansion program under Title XXI provides health care coverage to targeted low-income uninsured children, from birth through age 18 in families with incomes at or below 200 percent of the Federal poverty level. The separate CHIP program established on July 19, 2012, provides Medicaid coverage for the unborn children of pregnant women who are otherwise not Medicaid eligible

Choice Counseling: The provision of information and services designed to assist beneficiaries in making enrollment decisions; it includes answering questions and identifying factors to consider when choosing among managed care plans and primary care providers. Choice counseling does not include making recommendations for or against enrollment into specific

MCO

Claim: A bill for services, a line item of services, or all services for one member within a bill

Collusion: An agreement or cooperation between two or more persons or entities to accomplish a fraudulent, deceitful, or unlawful purpose

Commodities: Any equipment, material, supply, or goods; anything movable or tangible that is provided or sold

Commodities Description: Detailed descriptions of the items to be purchased; may include information necessary to obtain the desired quality, type, color, size, shape, or special characteristics necessary to perform the work intended to produce the desired results

Competition: The effort or action of two or more commercial interests to obtain the same business from third parties

Confidential Information: See Proprietary Information

Contract: An agreement between two or more parties creating obligations that are enforceable or otherwise recognizable at law; the writing that sets forth such an agreement

Contract Administration: The management of the contract which includes and is not limited to contract signing, contract amendments and any necessary legal actions

Contract Award: Document that officially awards a contract to a bidder(s) as the result of a competitive solicitation or a vendor(s) in a contract that qualifies for an exception or exemption from the competitive bidding requirements of the State Procurement Act

Contract Management: The management of day-to-day activities at the agency which includes but is not limited to ensuring deliverables are received, specifications are met, handling meetings and making payments to the Vendor

Contract Period: The duration of the contract

Contractor: See Vendor

Cooperative Purchasing: The combining of requirements of two or more political entities to obtain advantages of volume purchases, reduction in administrative expenses or other public benefits

Copyright: A property right in an original work of authorship fixed in any tangible medium of expression, giving the holder the exclusive right to reproduce, adapt and distribute the work

Cost Sheet: A required document that is completed by the Vendor in the prescribed format to show the Vendor’s pricing to provide the commodities or perform the services requested.

Critical Program Error: Any Program Error, whether or not known to the State, which prohibits or significantly impairs use of the Licensed Software as set forth in the documentation and intended in the contract vii SPB Form 22 | RFP Template | Effective 07012025

Customer Service: The process of ensuring customer satisfaction by providing assistance and advice on those commodities or services provided by a Vendor

Default: The omission or failure to perform a contractual duty

Deviation: Any proposed change(s) or alteration(s) to either the terms and conditions or deliverables within the scope of the written solicitation or contract

Disenrollment: A change in the status of a member from being enrolled with MCO to being enrolled with a different MCO, a change from being considered mandatory for participation in managed care to being ineligible for participation in managed care, and disenrolled from Medicaid

Encounter Date: Line-level utilization and expenditure data for services furnished to members through an MCO

Enrollee: An individual eligible for benefits under Title XIX or Title XXI of the Social Security Act and under the rules for participation in the Nebraska Medical Assistance Program but has yet selected an MCO or been assigned to the PACE provider

Enrollment Broker: The State’s contracted entity that performs choice counseling or enrollment activities, or both

Enrollment Files: A proprietary data file will be provided by the EB to an MCO’s and MMIS and the MCO’s to the EB. The enrollment file is information about enrollees and MMIS provides this to the EB and the MCOs.

Evaluation: The process of examining a solicitation response after opening to determine the bidder’s responsibility, responsiveness to requirements, and to ascertain other characteristics of the solicitation response that relate to determination of the successful award

Evaluation Committee: Individual(s) identified by the agency that leads the solicitation to evaluate solicitation responses

Extension: Continuance of a contract for a specified duration upon the agreement of the parties beyond the original Contract Period; not to be confused with “Renewal Period”

Fee-for-Service: A method of provider reimbursement based on payments for each service rendered.

Free on Board (F.O.B.) Destination: The delivery charges are included in the quoted price and prepaid by the Vendor.

Vendor is responsible for all claims associated with damages during delivery of product

Free on Board (F.O.B.) Point of Origin: The delivery charges are not included in the quoted price and are the responsibility of the agency. Agency is responsible for all claims associated with damages during delivery of product

Foreign Corporation: A foreign corporation that was organized and chartered under the laws of another state, government, or country

Goods: See Commodities

Health Care Provider: A health care professional or entity that provides health care services or goods.

Health Insuring Organization (HIO): An entity that provides or arranges for the provision of care and contracts on a prepaid capitated risk basis to provide a comprehensive set of services

Heritage Health: Nebraska’s Medicaid Managed Care Program

Information System(s): A combination of computing and telecommunications hardware and software that is used in: (a) the capture, storage, manipulation, movement, control, display, interchange, and/or transmission of information, i.e., structured data that may include digitized audio and video and documents, as well as non-digitized audio and video; and/or (b) the processing of information and non-digitized audio and video for purposes of enabling or facilitating a business process or related transaction

Installation Date: The date when the procedures described in “Installation by Vendor“ and “Installation by State” as found in the solicitation or contract are completed

Internal Quality Assurance: The continuous process of assuring appropriate and timely actions and operational improvements by the contractor’s employees and subcontractors

Interested Party: A person acting in their personal capacity or an entity entering into a contract or other agreement creating a legal interest therein viii SPB Form 22 | RFP Template | Effective 07012025

IServe: The State service delivery system for public benefits. Accessible through a toll-free telephone number and website

Late Bid/Proposal: An offer received after the Opening Date and Time

Late Solicitation Response: A solicitation response received after the Opening Date and Time

Licensed Software Documentation: The user manuals and any other materials in any form or medium customarily provided by the Vendor to the users of the Licensed Software which will provide the State with sufficient information to operate, diagnose, and maintain the Licensed Software properly, safely, and efficiently

Mandatory: Required, compulsory, or obligatory

May: Discretionary, permitted; used to express possibility

Member: A Medicaid enrollee who is currently enrolled with a specific MCO

Module (see System): A collection of routines and data structures that perform a specific function of software

Must: See Shall

National Institute for Governmental Purchasing (NIGP): National Institute of Governmental Purchasing – Source used for assignment of universal commodity codes to goods and services

Nebraska Medicaid Managed Care Program (NMMCP): NE Medicaid provides health care services to eligible elderly and disabled individuals and eligible low-income pregnant women, children, and parents. NE Medicaid also includes the CHIP, non-institutional home and community-based services for individuals qualified for Medicaid waivers, the aged, adults, and children with disabilities and infants and toddlers with special needs. NE Medicaid is administered by MLTC, DHHS. Effective January 1, 2017, NMMCP is called Heritage Health.

Non-core: See Catalog

Non-Responsive Solicitation Response: Any solicitation response that does not comply with the requirements of the solicitation or cannot be evaluated against the other solicitation responses

Non-negotiable: These clauses are controlled by state law and are not subject to negotiation

Opening Date and Time: Specified date and time for the opening of received, labeled, and sealed formal solicitation responses

Open Market Purchase: Authorization may be given to an agency to purchase items above direct purchase authority due to the unique nature, price, quantity, location of the agency, or time limitations by the AS Materiel Division, State Purchasing Bureau

Operating System: The control program in a computer that provides the interface to the computer hardware and peripheral devices, and the usage and allocation of memory resources, processor resources, input/output resources, and security resources

Outsourcing: The contracting out of a business process that an organization may have previously performed internally or for which an organization has a new need to an independent organization from which the process is purchased back

Payroll & Financial Center (PFC): Electronic procurement system of record

Performance Bond: An insurance agreement accompanied by a monetary commitment by which a third party (the surety) accepts liability and guarantees that the Vendor fulfills any and all obligations under the contract

Personal Property: See Commodities

Platform: A specific hardware and Operating System combination that is different from other hardware and Operating System combinations to the extent that a different version of the Licensed Software product is required to execute properly in the environment established by such hardware and Operating System combination

Point of Contact (POC): The person designated to receive communications and to communicate

Pre-Bid/Pre-Proposal Conference: A meeting scheduled for the purpose of clarifying a written solicitation and related ix SPB Form 22 | RFP Template | Effective 07012025 expectations

Primary Care Dentist (PCD): The main provider chosen by or assigned to the member to provide comprehensive oral health care.

Primary Care Provider (PCP): A medical professional chosen by or assigned to the member to provide primary care services. Provider types practicing within the scope of their respective Practice Acts may be Doctor of Medicine (MDs), Doctors of Osteopathic Medicine (DOs), nurse practitioners, and physician assistants

Product: Something that is distributed commercially for use or consumption and that is usually (1) tangible personal property,

(2) the result of fabrication or processing, and (3) an item that has passed through a chain of commercial distribution before ultimate use or consumption

Program Error: Code in Licensed Software that produces unintended results or actions or that produces results or actions other than those described in the specifications. A program error includes, without limitation, any Critical Program Error

Program Set: The group of programs and products, including the Licensed Software specified in the solicitation, plus any additional programs and products licensed by the State under the contract for use by the State

Project: The total scheme, program, or method worked out for the accomplishment of an objective, including all documentation, commodities, and services to be provided under the contract

Proposal: See Solicitation Response

Proprietary Information: Trade secrets, academic and scientific research work that is in progress and unpublished or other information that if released would give advantage to business competitors and service no public purpose. See Neb. Rev. Stat.

§ 84-712.05(3). In accordance with Attorney General Opinions 92068 and 97033, proof that information is proprietary requires identification of specific named competitor(s) advantaged by release of the information and the demonstrated advantage the named competitor(s) would gain by the release of information

Protest/Grievance: A complaint about a governmental action or decision related to the solicitation or resultant contract under SPB’s Protest Policy

Provider: Any individual or entity furnishing Medicaid services under an agreement with the Medicaid agency under the FFS model, or the managed care program, any individual or entity who/that is engage in the delivery of health care services and is legally authorized to do so by the State

Public Proposal Opening: The process of opening correctly submitted offers at the time and place specified in the written solicitation and in the presence of anyone who wishes to attend

Quote: See Solicitation Response

Recommended Hardware Configuration: The data processing hardware (including all terminals, auxiliary storage, communication, and other peripheral devices) to the extent used by the State as recommended by the Vendor

Recoupment: The recovery of any Medicaid funds that were paid incorrectly to an MCO or PACE provider

Release Date: The date of public release of the solicitation

Renewal Period: Optional contract periods subsequent to the original Contract Period for a specified duration with previously agreed to terms and conditions; not to be confused with “Extension”

Representative: Includes an agent, an officer of a corporation or association, a trustee, executor or administrator of an estate, or any other person legally empowered to act for another

Request for Proposal (RFP): See Solicitation

Request for Information (RFI): A general invitation to vendors requesting information for potential future solicitation. RFI is typically used as a research and information gathering tool for preparation of a solicitation

Responsible Bidder: A Vendor who has the capability in all respects to perform fully and lawfully all requirements with integrity and reliability to assure good faith performance

Responsive Bidder: A Vendor who has submitted a solicitation response which conforms to all requirements of the solicitation x SPB Form 22 | RFP Template | Effective 07012025

Retroactive Eligibility: Allows for coverage of medical bills incurred prior to the application date, provided the applicant was eligible during that period.

Shall: An order/command; mandatory

Should: Expected; suggested, but not necessarily mandatory

Software License: Legal instrument with or without printed material that governs the use or redistribution of licensed software

Sole Source – Commodity: When an item is available from only one source due to the unique nature of the requirement, its supplier, or market conditions

Sole Source – Services: A service of such a unique nature that the vendor selected is clearly and justifiably the only practical source to provide the service. Determination that the vendor selected us justifiably the sole source is based on either the uniqueness of the service or sole availability at the location required

Solicitation: A formal invitation to receive quotes in the form of a Request for Proposal or Invitation to Bid

Solicitation Bond: An insurance agreement, accompanied by a monetary commitment, by which a third party (the surety) accepts liability and guarantees that the Vendor will not withdraw the solicitation response

Solicitation Conference: A meeting scheduled for the purpose of clarifying a written solicitation and related expectations

Solicitation Response: An offer, quote, bid, or proposal submitted by a Vendor in response to a Solicitation

Specifications: The detailed statement, especially of the measurements, quality, materials, and functional characteristics, or other items to be provided under a contract

State: The State of Nebraska or Nebraska, as the context may require

Subcontractor: Individual or entity with whom the Vendor enters a contract to perform a portion of the work awarded to the Vendor

System (see Module): Any collection or aggregation of two (2) or more Modules that is designed to function, or is represented by the Vendor as functioning or being capable of functioning, as an entity

Termination:

Occurs when either Party, under a power created by agreement or law, puts an end to the contract prior to the stated expiration date; all obligations that are still executory on both sides are discharged but any right based on prior breach or performance survives

Third-Party: Any person or entity, including but not limited to fiduciaries, shareholders, owners, officers, managers, employees, legally disinterested persons, and subcontractors or agents, and their employees. It shall not include any entity or person who is an interested party to the contract or agreement

Trade Secret: Information, including but not limited to, a drawing, formula, pattern, compilation, program, device, method, technique, code, or process that (a) derives independent economic value, actual or potential, from not being known to, and not being ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use; and (b) is the subject of efforts that are reasonable under the circumstances to maintain its secrecy (see Neb. Rev. Stat. § 87-502(4))

Trademark: A word, phrase, logo, or other graphic symbol used by a manufacturer or Vendor to distinguish its product from those of others, registered with the U.S. Patent and Trademark Office

Upgrade: Any change that improves or alters the basic function of a product of service

Vendor: An individual or entity lawfully conducting business with the State, or licensed to do so, who seeks to provide and contract for goods or services under the terms of a Solicitation and/or Contract

Vendor Performance Report: A report completed by the using agency and submitted to Department of Health and Human Services documenting products or services delivered or performed which exceed or fail to meet the terms of the purchase order, contract, and/or solicitation specifications

Will: See Shall

Work Day: See Business Day xi SPB Form 22 | RFP Template | Effective 07012025

ACRONYM LIST

ACH: Automated Clearing House

ADA: Americans with Disabilities Act

ADD: Advanced Planning Document

ARO: After Receipt of Order

ASCII: American Standard Code for Information Interchange

BAFO: Best and Final Offer

BCP: Business continuity plan

BH: Behavioral Health

CAP: Corrective action plan

CBS: Claims broker services

CEF: Conditions for Enhanced Funding

CFR: Code of Federal Regulations

CHIP: Children’s Health Insurance Program

CMS: Centers for Medicare & Medicaid Services

COB: Close of Business

COI: Certificate of Insurance

CPA: Certified Public Accountant

CPU: Central Processing Unit

CR: Certification Review

CSV: Comma separated values

DAS: Department of Administrative Services

DEI: Diversity, Equity and Inclusion

DEIA: Diversity, Equity, Inclusion and Accessibility

DHHS: Department of Health and Human Services

DMA: Data management and analytics

DRP: Disaster recovery plan

EB: Enrollment broker

EES: Eligibility and enrollment solution

Federal DHHS: U.S. Department of Health and Human Services

FFS: Fee-for-service

F.O.B.: Free on Board xii SPB Form 22 | RFP Template | Effective 07012025

FQHC: Federally qualified health clinic

FTI: Federal tax information

FTP: File transfer protocol

FWA: Fraud, waste, and abuse

HCBS: Home and community-based services

HEDIS: Healthcare Effectiveness Data and Information Set

HHA: Heritage Health Adult

HIO: Health Insuring Organization

HIPAA: Health Insurance Portability and Accountability Act

HTTPS: Hypertext transfer protocol secure

ICT: Information and Communication Technology

IS: Information systems

IT: Information technology

ITB: Invitation to Bid

IVR: Interactive voice response

JMS/MO: Java Message Services/message oriented

MCO: Managed Care Organization

MITA: Medicaid Information Technology Architecture

MLTC: Nebraska DHHS, Division of Medicaid and Long-Term Care

MMIS: Medicaid management information system

NAC: Nebraska Administrative Code

NIGP: National Institute for Governmental Purchasing

NMMCP: Nebraska Medicaid Managed Care Program

NMPI: Nebraska Medicaid Program Integrity Unit

ORR: Operational Readiness Review

PA: Participating Addendum

PACE: Program of All-inclusive Care for the Elderly

PAHP: Prepaid ambulatory health plan

PCCM: Primary care case management

PCD: Primary care dentist

PCP: Primary care provider

PHI: Personal health information

PIHP: Prepaid inpatient health plan xiii SPB Form 22 | RFP Template | Effective 07012025

PII: Personally identifiable information

PM: Project Manager

PMLC: Project management life cycle

QA: Quality assurance

RFP: Request for Proposal

RHC: Rural health clinic

RTM: Requirements Traceability Metrix

SDLC: Systems development life cycle

SDP: State Disability Program

SHD: Systems help desk

SMC: Streamlined Modular Certification

SOA: Service-oriented architecture

SOAP: Simple object access protocol

SSL: Security sockets layer

SSP: System Security Plan

TBD: To be determined

TDD: Telecommunications Device for the Deaf

TMSIS: Transformed Medicaid Statistical Information System

VPN: Virtual private network

XML: Extensible Markup Language

SPB Form 22 | RFP Template | Effective 07012025

I. PROCUREMENT PROCEDURE

A. GENERAL INFORMATION

This solicitation is designed to solicit responses from qualified bidders who will be responsible for providing Nebraska Enrollment Broker Services at a competitive and reasonable cost.

Solicitation responses shall conform to all instructions, conditions, and requirements included in the solicitation.

Prospective bidders are expected to carefully examine all documents, schedules, and requirements in this solicitation, and respond to each requirement in the format prescribed. Solicitation responses may be found non-responsive if they do not conform to the solicitation.

B. PROCURING OFFICE AND COMMUNICATION WITH STATE STAFF AND EVALUATORS

Procurement responsibilities related to this solicitation reside with the Department of Health and Human Services.

The point of contact (POC) for the procurement is as follows:

RFP Number: 125920 O3 Name: Angellica Shasteen Procurement Contract Officer(s) Agency: Department of Health and Human Services Address: 301 Centennial Mall Lincoln, NE 68508 E-Mail: angellica.shasteen@nebraska.gov

From the date the solicitation is issued until the Intent to Award is issued, communication from the bidder is limited to the POC listed above. After the Intent to Award is issued, the bidder may communicate with individuals the State has designated as responsible for negotiating the contract on behalf of the State. No member of the State Government, employee of the State, or member of the Evaluation Committee is empowered to make binding statements regarding this solicitation. The POC will issue any answers, clarifications, or amendments regarding this solicitation in writing.

Only the SPB or awarding agency can award a contract. Bidders shall not have any communication with or attempt to communicate or influence any evaluator involved in this solicitation.

The following exceptions to these restrictions are permitted:

1. Contact made pursuant to pre-existing contracts or obligations;

2. Contact required by the schedule of events or an event scheduled later by the POC; and

3. Contact required for negotiation and execution of the final contract.

The State reserves the right to reject a bidder’s solicitation response, withdraw an Intent to Award, or terminate a contract if the State determines there has been a violation of these procurement procedures.

C. SCHEDULE OF EVENTS

The State expects to adhere to the procurement schedule shown below, but all dates are approximate and subject to change.

NOTE: All ShareFile links in the Schedule of Events below, are unique links for each schedule step. Please click the correct link for the upload step you are requesting.

Schedule of Events

ACTIVITY DATE/TIME

1. Release solicitation September 3, 2026

2.

Last day to submit written questions via email.

Questions should be emailed to: dhhs.rfpquestions@nebraska.gov

October 9, 2026

3.

Solicitation Conference – Webex Meeting - Cisco Webex

Meeting number (access code): 2488 415 3283 Meeting password: AFqdPYE8t97

October 14, 2026

4. DHHS responds to written questions through solicitation “Addendum” to be posted to the Internet at: http://das.nebraska.gov/materiel/bidopps.html October 14, 2026

5.

Electronic Solicitation Opening – Online Via Webex

IT IS THE BIDDER’S RESPONSIBILTY TO UPLOAD ELECTRONIC FILES

BY OPENING DATE AND TIME. EXCEPTIONS WILL NOT BE MADE FOR

TECHNOLOGY ISSUES.

ShareFile Electronic Solicitation Submission Link:

ShareFile - State of Nebraska

Join Webex Meeting - Cisco Webex

Meeting number (access code): 2485 378 7526

Meeting password: RPiwAwDi348

October 28, 2026

2:00 PM

Central Time

6. Review for conformance to solicitation requirements October 29, 2026

7. Evaluation period October 30 – November 13,

8. “Vendor Demonstrations” (if required) TBD

9. Post “Intent to Award” to the Internet at:

https://das.nebraska.gov/materiel/bidopps.html November 13, 2026

10. Contract finalization period November 13 – January 20,

11. Contract award February 2, 2026

12. Contract start date October 1, 2027 mailto:dhhs.rfpquestions@nebraska.gov https://sonvideo.webex.com/wbxmjs/joinservice/sites/sonvideo/meeting/download/d3e4541b35e74222b766b2c1f192e17c?MTID=m02ee11ade8af6163a47f18b0869cc4f6 http://das.nebraska.gov/materiel/bidopps.html https://nebraska.sharefile.com/share/getinfo/r93c4afc5ceef45fdae6e145348d51501 https://sonvideo.webex.com/wbxmjs/joinservice/sites/sonvideo/meeting/download/59bee106cd314236b014f123333aac98?MTID=m23752e632e6bbb1b3695882c3bc7356e

D. WRITTEN QUESTIONS AND ANSWERS

Questions regarding the meaning or interpretation of any solicitation provision must be submitted in writing to Department of Health and Human Services and clearly marked “Solicitation Number 125920 O3; Nebraska Medicaid Enrollment Broker Questions”. The POC is not obligated to respond to questions that are received late per the Schedule of Events.

Bidders should submit questions for any items upon which assumptions may be made when preparing a response to the solicitation. Any solicitation response containing assumptions may be deemed non-responsive and may be rejected by the State. Solicitation responses will be evaluated without consideration of any known or unknown assumptions of a bidder. The contract will not incorporate any known or unknown assumptions of a bidder.

Questions should be uploaded using the ShareFile link provided in the solicitation Schedule of Events, Section I.C.

It is recommended that bidders submit questions using the following format:

RFP Section Reference

RFP Page Number Question

Written answers will be posted at https://das.nebraska.gov/materiel/bidopps.html per the Schedule of Events.

E. SOLICITATION CONFERENCE

A solicitation conference will be held per the Schedule of Events. Attendance at the solicitation conference is required.

Vendors will have an opportunity to ask questions at the conference to assist in the clarification and understanding of the solicitation requirements. Questions that have a material impact on the solicitation or solicitation process, and relevant to all Vendors will be answered in writing and posted at https://das.nebraska.gov/materiel/bidopps.html. An answer must be posted to be binding on the State. The State will attempt to provide verbal answers to questions that do not impact the solicitation or process, and are only of interest to an individual Vendor during the conference. If a Vendor feels it necessary to have a binding answer to a question that was answered verbally, the question should be submitted in writing per the Schedule of Events.

F. NOTICE OF INTENT TO ATTEND MANDATORY SOLICITATION CONFERENCE

Vendors should notify DHHS of their intent to attend by submitting an "Intent to Attend the Solicitation Conference Form" by uploading the Form using the ShareFile link provided in the Schedule of Events, Section I.C.

G. SECRETARY OF STATE/TAX COMMISSIONER REGISTRATION REQUIREMENTS (Nonnegotiable) All bidders must be authorized to transact business in the State of Nebraska and comply with all Nebraska Secretary of State Registration requirements. The bidder who is the recipient of an Intent to Award may be required to certify that it has complied and produce a true and exact copy of its current (within ninety (90) calendar days of the intent to award) Certificate or Letter of Good Standing, or in the case of a sole proprietorship, provide written documentation of sole proprietorship and complete the United States Citizenship Attestation Form, available on the Department of Administrative Services website at:

https://das.nebraska.gov/materiel/docs/pdf/Individual%20or%20Sole%20Proprietor%20United%20States%20Attest ation%20Form%20English%20and%20Spanish.pdf This should be accomplished prior to execution of the contract.

H. ETHICS IN PUBLIC CONTRACTING

The State reserves the right to reject solicitation responses, withdraw an intent to award or award, or terminate a contract if an ethical violation has been committed, which includes, but is not limited to:

1. Offering or giving, directly or indirectly, a bribe, fee, commission, compensation, gift, gratuity, or anything of value to any person or entity in an attempt to influence the bidding process;

2. Utilizing the services of lobbyists, attorneys, political activists, or consultants to influence or subvert the bidding process;

3. Being considered for, presently being, or becoming debarred, suspended, ineligible, or excluded from contracting with any state or federal entity:

4. Submitting a solicitation response on behalf of another Party or entity; and

5. Colluding with any person or entity to influence the bidding process, submit sham solicitation responses, preclude bidding, fix pricing or costs, create an unfair advantage, subvert the solicitation response, or prejudice the State.

The bidder shall include this clause in any subcontract entered into for the exclusive purpose of performing this contract.

Bidder shall have an affirmative duty to report any violations of this clause by the bidder throughout the bidding process and throughout the term of this contract for the awarded bidder and their subcontractors.

https://das.nebraska.gov/materiel/bidopps.html https://das.nebraska.gov/materiel/bidopps.html https://das.nebraska.gov/materiel/docs/pdf/Individual%20or%20Sole%20Proprietor%20United%20States%20Attestation%20Form%20English%20and%20Spanish.pdf https://das.nebraska.gov/materiel/docs/pdf/Individual%20or%20Sole%20Proprietor%20United%20States%20Attestation%20Form%20English%20and%20Spanish.pdf

I. DEVIATIONS FROM THE SOLICITATION

The requirements contained in the solicitation (Sections II through VI) become a part of the terms and conditions of the contract resulting from this solicitation. Any deviations from the solicitation in Sections II through VI must be clearly defined by the bidder in its solicitation response and, if accepted by the State, will become part of the contract. Any specifically defined deviations must not be in conflict with the basic nature of the solicitation, requirements, or applicable state or federal laws or statutes. “Deviation”, for the purposes of this solicitation, means any proposed changes or alterations to either the contractual language or deliverables within the scope of this solicitation. The State discourages deviations and reserves the right to reject proposed deviations.

J. SUBMISSION OF SOLICITATION RESPONSES

The State is only accepting electronic responses submitted in accordance with this solicitation. The State will not accept solicitation responses by mail, email, voice, or telephone, unless otherwise explicitly stated in writing by the State.

Pages may be consecutively numbered for the entire solicitation response or may be numbered consecutively within sections. Figures and tables should be numbered and referenced in the text by that number. They should be placed as close as possible to the referencing text.

The Technical Responses should not contain any reference to dollar amounts. However, information such as data concerning labor hours and categories, materials, subcontracts and so forth, shall be considered in the Technical Response so that the bidder’s understanding of the scope of work may be evaluated. The Technical Response shall disclose the bidder’s technical requirements in as much detail as possible, including, but not limited to, the information required by the Technical Response instructions.

It is the bidder’s responsibility to ensure the solicitation response is received electronically by the date and time indicated in the Schedule of Events. Solicitation Responses must be submitted via ShareFile by the date and time of the opening per the Schedule of Events. No late solicitation responses will be accepted.

It is the responsibility of the bidder to check the website for all information relevant to this solicitation to include addenda and/or amendments issued prior to the opening date. The website can be found here:

https://das.nebraska.gov/materiel/bidopps.html.

Emphasis should be concentrated on conformance to the solicitation instructions, responsiveness to requirements, completeness, and clarity of content. If the solicitation response is presented in such a fashion that makes evaluation difficult or overly time consuming the State reserves the right to reject the solicitation response as non-conforming.

The ShareFile link for uploading Solicitation Response(s) is provided in the Schedule of Events, Section I.C.

***UNLESS OTHERWISE NOTED, DO NOT SUBMIT DOCUMENTS

THAT CAN ONLY BE ACCESSED WITH A PASSWORD***

1. Bidders must submit responses via ShareFile using the solicitation submission link.

Note: Not all browsers are compatible with ShareFile. Currently Google Chrome, Internet Explorer, Microsoft Edge, Safari, and Firefox are compatible. After the bidder clicks the solicitation response submission link, the bidder will be prompted to enter contact information including an e-mail address. By entering an e-mail address, the bidder should receive a confirmation email confirming the successful upload directly from ShareFile.

ShareFile link for uploading solicitation response(s) provided in the Schedule of Events, Section I.C.

a. The Solicitation response and Proprietary information should be uploaded as separate and distinct files.

i. If duplicated responses are submitted, the State will retain only the most recently submitted response.

ii. If it is the bidder’s intent to submit multiple responses, the bidder must clearly identify the separate submissions.

iii. It is the bidder’s responsibility to allow time for electronic uploading. All file uploads must be completed by the Opening date and time per the Schedule of Events. No late responses will be accepted.

b. ELECTRONIC SOLICITATION RESPONSE FILE NAMES

The bidder should clearly identify the uploaded solicitation response files. To assist in identification the bidder should use the following naming convention:

i. 125920 O3 Company Name If multiple files are submitted for one solicitation response, add number of files to file names:

125920 O3 Company Name File 1 of 2 125920 O3 Company Name File 2 of 2

ii. If multiple responses are submitted for the same solicitation, add the response number to the file names:

125920 O3 Company Name Response 1 File 1 of 2

The “Contractual Agreement Form” must be signed manually in ink or by…