REQUEST FOR PROPOSALS

The State of Ohio, through the Department of Administrative Services, Office of Procurement Services, on behalf of the Department of Administrative Services, is issuing the following Request for Proposals (RFP):

Medical Plan Third-Party Administrator RFP

Proposals received after the due date and time will not be evaluated.

This RFP consists of seven sections, eight parts, and 15* exhibits, totaling 100 consecutively numbered pages excluding the exhibits. Exhibits are included with this RFP as separate documents. Please verify that you have a complete copy of all documents.

*Indicates an update to the number of exhibits included in the RFP, per amendment 1, effective 10/20/26.

TABLE OF CONTENTS

RFP Details

Contract

Exhibits to RFP and Contract

*Exhibit 15 State of Ohio Claims and Enrollment Data

*Indicates the addition of Exhibit 15, per amendment 1, effective 10/20/26.

RFP DETAILS

Section 1 - Overview

A. Definitions in this RFP

The following definitions apply to the RFP and Contract.

Agency: The State entity or entities on behalf of which this RFP is issued.

Contract: The contract resulting from this RFP.

Contractor: The selected Offeror.

DAS: Ohio Department of Administrative Services.

Deliverable: Specified portions of the Work that must be provided by the Contractor to meet contractual requirements.

Member: An employee, employee’s spouse, or employee’s child who is covered by the State’s medical plan.

Offeror: A supplier submitting a Proposal in response to this RFP.

Plan Year: The period from July 1 to June 30 of the following calendar year.

Proposal: Competitive sealed proposals submitted by Offerors in response to this RFP.

State: State of Ohio.

Work: The scope of work described in this RFP.

B. Term of Contract

Once awarded, the term of the Contract will be as set forth in Part 8, Draft Contract. The State may solely renew this Contract at its discretion for a period of one month at the end of the initial term and each renewal term. Any further renewals will be by mutual agreement between the Contractor and the State as set forth in Part 8. The Contract and each renewal are subject to and contingent upon the discretionary decision of the Ohio General Assembly to appropriate funds for this Contract in each new biennium. The State may renew all or part of this Contract subject to the satisfactory performance of the Contractor and the needs of the Agency.

C. Purpose and Background

The purpose of this RFP is to solicit Proposals for one or more Contractors, evaluated by region, to administer the delivery of medical health benefits to the State’s employees and their dependents with innovative best practices. The State of Ohio’s self-insured medical plan, Ohio Med, offers three plan options: preferred provider organization (Ohio Med PPO), narrow network plan (Ohio Med Select), and a high-deductible health plan (Ohio Med HDHP). The Contractor must administer the existing plan designs with no exceptions.

State of Ohio employees are a geographically dispersed workforce of approximately 50,500 employees located in approximately 1,300 work locations concentrated in Ohio, with a limited number of employees dispersed throughout the United States. Currently, the State provides self-insured medical benefits, to approximately 43,000 employees (both union and exempt). The combination of employees and their dependents represents approximately 103,000 covered lives.

The State has approximately 200 participants (former employees and/or dependents) enrolled in COBRA.

The State has approximately 8,530 employees enrolled in the healthcare flexible spending accounts (FSA) and limited purpose spending account programs, and approximately 792 employees enrolled in the dependent care spending account program.

The State offers self-insured medical, dental and vision benefits to approximately 225 death benefit fund recipients. Currently, 130 Members are enrolled in this program. Additional information on this program can be found here: https://das.ohio.gov/employee-relations/benefits-administration/opf-dbfr.

The table below displays the current medical TPAs and other benefit offerings with corresponding plan TPAs. These TPAs are subject to change.

Telehealth – Live Health Online Anthem Blue Cross and Blue Shield/ Live Health Online

The following resources contain information relevant to the Work:

1. Article 20 of the Ohio Civil Service Employees Association (OCSEA) Collective Bargaining Agreement (2024 – 2027)

2. 2026 Preventative Care Guidelines

3. Current Medical Third-Party Administrator Information

4. Ohio Med PPO Plan, Ohio Med HDHP, Ohio Med Select (Narrow Network)

5. Take Charge Live Well Incentive Program

The Agency is seeking Contractors who will increase the quality of care while reducing costs for the State’s Members through effective healthcare services. The Agency is also seeking a Contractors that will offer solutions to simplify access to care, increase engagement in existing programs, increase healthy outcomes, and reduce overall costs for Members and the State. The State is committed to improving the healthcare experience for its employees and Members. The Agency recognizes that navigating healthcare systems can be complex and constantly changing and seeks Contractors who can market healthcare services to Members and educate Members to be better healthcare consumers, including promoting the reduction of emergency room visits and the increase of Members’ use of the Contractors’ website tools such as cost comparison tools.

D. Scope of Work Overview

An overview of the Work is provided below. The scope of work and requirements are provided in greater detail within Part 1, Scope of Work.

The Contractor must administer all claims incurred on or after July 1, 2027. If the result of this RFP is a change in contractors, the Contractor must make all arrangements necessary to ensure a smooth transition of care, administration of services, verification of eligibility, and obtaining claims history from the prior contractors.

The Contractor must:

1. Provide a strong, committed and proactive account management team;

2. Provide timely and responsive updates to inquiries and questions from the Agency;

3. Provide competitive administrative fee pricing, network discounts, and aggressive service level agreements;

4. Provide accurate, timely and responsive management of claims;

5. Provide recommendations for improvement of the Agency’s administrative processes;

6. Offer superior customer service to the State of Ohio’s Members including a proactive, analytical approach to analyzing the State’s Members’ claims experiences.

7. Provide insight into upcoming trends in the market.

8. Partner effectively with the Agency’s other business partners, including, pharmacy, behavioral health, care navigator, population health management, and data warehouse, to bring and implement innovative solutions that enhance both the health and productivity of the State’s workforce.

9. Provide seamless and integrated delivery of all Work including any Work delivered using subcontractors, affiliates, or partners.

10. Provide forward-thinking best practices for proactive management and decision support.

11. Collaborate with the Agency to implement innovative practices in a cooperative and timely manner.

12. Provide creative, proactive, and flexible solutions to managing the State’s costs.

13. Provide comprehensive management reporting to facilitate and effective analysis by the State of its financial experience.

14. Provide the necessary technical and administrative support for a smooth implementation and/or transition of the Work.

Section 2 – Procurement Authority, RFP Overview, and Schedule of Events

A. Procurement Authority and RFP Overview

This is a request for competitive sealed proposals under Section 125.071 of the Ohio Revised Code (R.C.) and Section 123:5-1-08 of the Ohio Administrative Code (OAC). The State of Ohio, through the Department of Administrative Services, Office of Procurement Services, on behalf of the Department of Administrative Services (the Agency), is soliciting Proposals for this Medical Plan Third-Party Administrator RFP.

If a suitable Proposal is made by an Offeror in response to this RFP, the State, through DAS, may enter into the Contract. The Contractor will perform all or part of the Work as specified in the Contract. This RFP provides details on what is required to submit a Proposal for the Work, how the State will evaluate the Proposals, and what will be required of the Contractor in performing the Work.

The State may award one or more Contracts, by the regions identified in Exhibit 5, for this RFP. Approximately 300 employees currently reside out of State and are not captured in the zip codes in Exhibit 5. The State reserves the right to assign the out of State employees to any region during evaluation or after Contract award.

B. Schedule of Events

The schedule of events for the RFP process and Work is provided in the solicitation general information section in OhioBuys for this RFP. The State may change this schedule at any time. If the State changes the schedule before the Proposal due date, it will post an amendment to this RFP in the OhioBuys public portal. Offerors must not contact Agency staff or DAS (except as provided in this RFP) until the Contract award is announced.

There are references in this RFP to the Proposal due date. Unless it is clearly stated to the contrary, any such reference means the date and time that the Proposals are due.

Proposals received after 1:00 p.m. Eastern time on the Proposal due date will not be evaluated. Any failure to meet a deadline or any objection to the dates for performance of the Work may result in the State refusing to consider a Proposal.

Section 3 – General Instructions to Offeror

A. Introduction to General Instructions

The following sections provide details on how to get more information about this RFP and how to respond to this RFP. All responses must be complete and in the prescribed format.

B. Contacts

During the performance of the Work, a State representative (Agency Representative) will represent the Agency and be the primary contact for matters relating to the Work. The Agency Representative will be designated after the Contract award.

C. Inquiries

Offerors may not contact the State directly at any time during the solicitation process, however Offerors may make inquiries regarding this RFP any time during the inquiry period listed in OhioBuys.

To make an inquiry, Offerors must login to OhioBuys, navigate to the solicitation, open the Inquiry tab and submit their inquiry. Offerors will not receive a personalized e-mail response to their question, nor will they receive notification when the question has been answered. Offerors may view inquiries and responses on the OhioBuys Public Solicitations page by opening the Solicitation Overview and navigating to the inquiries section of that page.

Offerors are to base their proposal responses, and the details and costs of their proposed projects, on the requirements and performance expectations established in this RFP.

The State is under no obligation to acknowledge questions submitted through the Q&A process if those questions are not in accordance with these instructions or deadlines. The State does not consider questions asked during the inquiry period through the inquiry process as exceptions to the requirements or the terms and conditions of this RFP.

The State will attempt to respond to all inquiries within three business days of receipt, excluding State holidays. The State will not respond to any inquiries received after 8:00 a.m. on the inquiry end date listed in OhioBuys. The State will use its discretion in deciding whether to provide responses as part of this RFP process. Responses to inquiries are not considered changes to the RFP.

D. Restrictions on Communication

Other than the communication options described in this RFP, Offerors must not make unsolicited contact with any elected official or office of the State, any staff member of DAS or the Agency, or any agent or representative of DAS or the Agency, regarding this RFP. Offerors must not represent themselves to anyone as having the endorsement of the Agency or the State, nor as the Agency’s next supplier of the Work. For contractors currently doing business with the Agency, any communication regarding this RFP is prohibited except as provided for in this RFP. Any such unauthorized contact may result in an Offeror being disqualified from further consideration under this RFP. The State will not discuss the particulars of this RFP process with external parties.

E. Amendments to this RFP

If the State decides to revise this RFP before the Proposal due date, an amendment will be issued in OhioBuys as a new round. If an Offeror has submitted a Proposal prior to an amendment being issued and wishes to be considered, the Offeror must resubmit their Proposal in response to the latest round of the RFP. Proposals submitted in response to amended RFPs prior to the most recent amendment will not be opened or evaluated. The State may issue amendments to this RFP any time before Proposals are due, and it is each Offeror’s responsibility to check for amendments and other current information regarding this RFP.

Unless otherwise stated in the notice by the State, modifications and withdrawals must be submitted within OhioBuys prior to the end date of the amendment response period. If this RFP provides for a negotiation phase, this procedure will not apply to changes negotiated during that phase. Any modification that is broader in scope than the State has authorized may be rejected and treated as a withdrawal of the Offeror’s Proposal.

F. Proposal Submittal

Each Offeror must submit a technical proposal and a cost proposal as separate sections of its Proposal before the Proposal due date and time and pursuant to the instructions in Section 4, Requirements for Proposals. Proposals, including all components of the Proposals, must not be password protected or the State may reject any such Proposals.

Each section must be submitted in its own separate, electronic submission as indicated by the solicitation questionnaire. The submission with the technical proposal will be electronically sealed (the technical envelope), and the submission with the cost proposal will be separately electronically sealed (the financial envelope).

Each requirement of a Proposal represents only a part of the total basis for a decision to award the Contract, and a failure by an Offeror to make a required submission or meet a Mandatory Requirement (see Section 6, if applicable) normally will result in a rejection of that Proposal. The value assigned to each requirement is used to determine which Proposal is the most advantageous to the State in relation to the other Proposals received. It is not a basis for determining the importance of meeting that requirement.

Offerors must submit their Proposals electronically in OhioBuys before the noted time on the Proposal due date. Paper submissions will be destroyed and will not be considered. OhioBuys will not allow submission or modification to a submission after the deadline. An Offeror submitting an electronic Proposal must allow for adequate time for uploading a Proposal prior to the due date and time. Technical difficulties experienced by the Offeror will not be an exception.

Each Offeror must carefully review the requirements of this RFP and the contents of its Proposal. Once opened, Proposals cannot be altered or withdrawn, except as allowed by this RFP.

The State is not responsible for the accuracy of any information regarding this RFP that was gathered through a source other than the inquiry process described in the RFP.

The State may reject any Proposal if the Offeror takes exception to the terms and conditions of this RFP, includes unacceptable assumptions or conditions in its Proposal, fails to comply with the procedure for participating in the RFP process, or fails to meet any requirement of this RFP. The State also may reject any Proposal it believes is not in its interest to accept, cancel this RFP, or decide not to award a Contract to any or all of the Offerors responding to this RFP.

All Proposals and other material that Offerors submit will become the property of the State and may be returned only at the State's option. All Proposals will be open to the public after the State has awarded the Contract.

The State will retain all Proposals, or a copy of them, as part of the Contract file for at least six years. After the six-year retention period, the State may dispose of the Proposals and any copies of them.

The State is not responsible for any costs an Offeror incurs in responding to this RFP or from participating in the evaluation process or negotiations process (if any), regardless of whether the State awards the Contract through this process, decides not to go forward with the Contract award, cancels this RFP for any reason, or contracts for the Work through some other process or through another RFP.

G. Rejection of Proposals Generally

The State may reject any Proposal for the reasons listed in this RFP, that fails to comply with the procedure for participating in the RFP process, that fails to meet the RFP requirements, or that is not in the State’s interest to consider or to accept. In addition, the State may cancel this RFP, reject all Proposals, and seek to do the Work through a new RFP or by other means.

H. Exceptions

The State may reject any Proposal if the Offeror takes exception to the terms and conditions of the Contract or includes unacceptable assumptions or conditions in its Proposal.

I. Proprietary Information

As set forth in OAC 123:5-1-07 and 123:5-1-08, if an Offeror includes in its Proposal information it considers exempt from disclosure in a public records request, it must submit a redacted version of any document containing such information, as further described in this paragraph. Offerors must only redact (black out) the specific language that is exempt from disclosure pursuant to the Ohio Public Records Act. Examples of actions that are not acceptable for the protection of information in a Proposal include: (a) redaction of sections in their entirety simply because they may contain some information exempt from disclosure pursuant to the Ohio Public Records Act; (b) inclusion of a blanket confidentiality or copyright notice anywhere in the Proposal; and (c) redaction of the cost proposal in its entirety. Prices, makes, models, catalog numbers of the items offered, deliveries, and terms of payment will be available for public inspection regardless of any designation to the contrary.

In addition to the redacted document(s), Offerors must submit a list of each redaction, using the Offeror Redaction Justification Form (Form 7k) in Part 7, with a detailed legal explanation for each redaction to demonstrate that the redacted information is protected under the Ohio Public Records Act. A blanket statement that all redactions are exempt from disclosure pursuant to the Ohio Public Records Act and/or the Uniform Trade Secrets Act is not a sufficient explanation. The redacted version(s) must be submitted as an electronic copy in a searchable PDF format. The redacted version(s) and accompanying explanation, as submitted, will be available for inspection and released in response to public records requests.

By submitting a redacted Proposal, the Offeror agrees to indemnify the State, DAS, and the Agency for any court costs, statutory damages, attorney fees, or other award issued against the State, DAS, or the Agency for any violation of the Ohio Public Records Act resulting from the State, DAS, or the Agency providing the Offeror’s redacted version of its Proposal in response to a public records request.

By not submitting a redacted version of the Proposal with accompanying explanation, an Offeror consents to the release of the original Proposal submission in response to a public records request. If an improperly redacted version or insufficient explanation is submitted, the State will advise the Offeror in writing what portions of the Proposal are subject to disclosure in response to public records requests.

J. Changes to Proposals

The State will allow modifications of Proposals only if the State receives them before the Proposal due date. No modifications will be permitted after the Proposal due date, except as authorized by this RFP.

K. Offeror Warranties

By submitting a Proposal, the Offeror acknowledges it has read this RFP, understands it, and agrees to be bound by the requirements of this RFP.

Ohio Revised Code 9.24 prohibits the State from awarding a contract to any entity against whom the Auditor of State has issued a finding for recovery (a Finding) if the Finding is unresolved at the time of the award. This also applies to renewals of contracts. By submitting a Proposal, the Offeror warrants it is not subject to an unresolved Finding under R.C. 9.24 at the time of its submission. Additionally, the Offeror warrants it will notify DAS in writing immediately upon becoming subject to such an unresolved Finding after submitting its Proposal and before the award of a Contract under this RFP. Further, the State may treat any unresolved Finding against the Contractor that prevents a renewal of the Contract as a breach in accordance with the provisions of the Contract.

L. Notice on Use of Social Security Numbers as Federal Tax Identification Numbers

If an Offeror uses its Social Security Number as its Federal Taxpayer Identification Number, please be aware that the information submitted is a public record, and the State may be compelled by Ohio law to release Federal Taxpayer Identification Numbers as a public record. If an Offeror does not want to have its Social Security Number potentially disclosed as a Federal Taxpayer Identification Number, the State encourages Offerors to use a separate Employee Identification Number (EIN) obtained from the United States Internal Revenue Service to serve as the Federal Taxpayer Identification Number.

M. Offeror Registration

Offerors must provide evidence that they are registered with Ohio Shared Services to do business in the State of Ohio. To register to do business in Ohio and to access supplier forms, see Form 7b.

N. Multiple or Alternate Proposals

The State will accept multiple Proposals from a single Offeror, but the State requires each such Proposal be submitted separately from every other Proposal the Offeror makes. Additionally, the Offeror must treat every Proposal submitted as a separate and distinct submission and include in each Proposal all materials, information, documentation, and other items this RFP requires for a Proposal to be complete and acceptable. No alternate Proposal may incorporate materials by reference from another Proposal made by the Offeror or refer to another Proposal. The State will judge each alternate Proposal on its own merit.

O. Debriefing and Protests

The State maintains a policy that debriefing of the evaluation process will not be conducted. Offerors should not contact the State either during or after the solicitation process to request a debriefing. In lieu of a debriefing, Offerors may file a public records request with the State using the following link, https://ohiobuys.ohio.gov/page.aspx/en/prj/foia_request_extranet_manage.

This protest language only pertains to this RFP. An Offeror may file a protest objecting to the process of soliciting the Proposals or an Offeror objecting to the subsequent award of a Contract resulting from the RFP. The protest must be in writing and contain the following information:

1. The name, address, and telephone number of the protester;

1. The name and number of the RFP being protested;

1. A detailed statement of the legal and factual grounds for the protest, including copies of any relevant documents;

1. A request for a ruling by the State;

1. A statement as to the form of relief requested from the State; and

1. Any other information the protester believes to be essential to the determination of the factual and legal questions at issue in the written request.

The State will consider a timely protest if it is received at the filing location below within the following periods:

1. An Offeror must file a protest based on alleged improprieties in the issuance of the RFP or any other event preceding the Proposal due date, which are apparent or should be apparent, no later than five business days prior to the Proposal due date.

1. If the protest relates to the recommendation of the evaluation team for an award of the Contract, an Offeror must file the protest as soon as practicable after the Offerors are notified of the decision by the State regarding the Proposals.

Offerors must file all protests at the following location:

Department of Administrative Services Office of Procurement Services Records_Admin@das.ohio.gov SUBJECT: Insert this RFP Number and Index Number

P. Disclosure of Proposal Contents

The State will seek to open the Proposals in a manner that avoids disclosing their contents. Additionally, the State will seek to keep the contents of all Proposals confidential until the Contract is awarded.

Q. Unfair Competitive Advantage

Any and all prior work performed by the Offeror or its proposed subcontractor(s) that the State determines results in an unfair competitive advantage to that Offeror may result in the Offeror’s Proposal being rejected due to a conflict of interest. Pursuant to OAC 123:5-1-10, if an Offeror developed or assisted with the development of specifications for this RFP, the Offeror is ineligible to submit a Proposal and the Offeror’s Proposal will be rejected.

R. Nondisclosure Agreement for Exhibits 9 and 10

A potential Offeror must send its completed and signed nondisclosure agreement (NDA) (Exhibit 14) to Shaun Roderer at shaun.roderer@das.ohio.gov by November 4, 2026, to gain access to Exhibits 9 and 10. The templates will be provided upon confirmation of proper execution of the NDA.

The State will not accept any proposed changes to this NDA. It is the Offeror's responsibility to sign the NDA and submit it in a timely manner to obtain Exhibits 9 and 10. The State is not responsible for any delay in execution of the NDA that results in an Offeror not submitting a timely Proposal.

Section 4 – Requirements for Proposals

A. Proposal Format

These instructions describe the required format for a responsive Proposal.

Each Proposal must include sufficient data to allow the State to verify the total cost for the Work and all of the Offeror's claims of meeting the RFP's requirements. Each Proposal must respond to every request for information in this RFP, whether the request requires a simple "yes" or "no" or requires a detailed explanation. Simply repeating the RFP's requirement and agreeing to comply may be an unacceptable response and may cause the Proposal to be rejected.

Proposals should use a consistent contrasting font and color so that the responses are readily distinguishable to the State; using the color blue to provide responses is suggested to contrast with the black text of this document. Formats are acceptable that use different typefaces, styles, or shaded backgrounds, so long as the use of these formats is consistent throughout the Offeror’s Proposal and readily distinguishable from the original RFP. Below is an example of the required format for responding to the RFP requirements. Alterations to the State-provided RFP language are strictly prohibited. The State will electronically compare Offeror Proposals to the posted RFP, and deviations or alterations to the State’s RFP requirements may result in a rejection of the Proposal.

Illustrative Example: Customers Served in the Widget Space

Instructions: The Offeror is to describe the customers (i.e., companies, agencies, entities, etc.) served in the Widget domain and the nature of the services provided, as well as the duration of the service.

Offeror Response: The Acme Corporation has been in business for over 20 years. Acme is a leading supplier of Widget and Widget-based services with clients in a variety of sectors, including public (23 states) and private (125 companies).

Offerors are advised to limit Offeror marketing statements and pre-printed technical inserts to the area(s) of the Proposal applicable to those statement(s) and not include duplicative or otherwise repetitive statements throughout its Proposal.

Any additional links or documents incorporated by reference by the Offeror will not become part of the Contract unless expressly accepted by the State.

The Offeror may include any additional information it believes is relevant. All pages, except pre-printed technical inserts, must be sequentially numbered. Any material deviation from the format outlined in this RFP may result in a rejection of the non-conforming Proposal.

Technical Proposal: The Offeror’s technical proposal must be submitted in Microsoft Word® if possible (certain forms may be submitted as PDFs) through OhioBuys and as instructed in the technical questionnaire in OhioBuys. The technical proposal consists of all questionnaire responses and documents submitted in response to this RFP excluding the cost proposal. All technical proposal documents must be submitted in the order listed in subsection B(1) below.

Cost Proposal: The Offeror’s cost proposal must be submitted through OhioBuys as instructed in the cost questionnaire in OhioBuys. The cost proposal consists of a separate cost section as described in subsection B(2) below and in the required format of Part 5.

B. Proposal Specifics

Each Proposal must contain the following components.

1. Technical Proposal Components

a. Required Forms. Each Proposal must include the completed forms listed below. All required forms are included in Part 7 unless otherwise indicated.

i. Offeror Certification Form (Form 7a). The Offeror must complete the Offeror Certification Form.

ii. Offeror Registration Form (Form 7b). The Offeror must use the Offeror Registration Form to register with the State as applicable.

iii. Independent Contractor Acknowledgement Form (Form 7c). Unless the Offeror is a “business entity” as that term is defined in R.C. 145.037 (“an entity with five or more employees that is a corporation, association, firm, limited liability company, partnership, sole proprietorship, or other entity engaged in business”), the Offeror must have any individual performing services under the Contract complete the Independent Contractor Acknowledgement Form

iv. Subcontractor Utilization Form (Form 7d). For each proposed subcontractor, the Offeror must submit a completed Subcontractor Utilization Form signed by someone authorized to legally bind the subcontractor.

The Offeror must disclose all subcontractors it will utilize to complete any Work including customer service, claims processing, disease management, data warehouse, etc. Form 7d is not required for subcontractors utilized by the Offeror enterprise-wide and not specifically for the State’s Contract.

v. Offeror Profile Form (Form 7e). The Offeror must complete the Offeror Profile Form to describe the Offeror’s capability, capacity, and experience in support of the requirements in this RFP. The contact person listed must be the primary point of contact for any questions about the Proposal. Additionally, the Contract Signatory listed must be the individual authorized to sign the Contract for the Offeror if awarded.

The form must include the date the Offeror was established, its leadership, number of employees and any other background information that will help the State gauge the ability of the Offeror to fulfill the obligations of the Contract. The background information must include the Offeror’s background as well as a description of the personnel, internal procedures, and any other resources required under the terms of the Contract to ensure successful performance and Contract compliance. The Offeror must describe its current operational capacity and the ability to perform the additional workload in the Contract.

The financial stability of the Offeror must also be described and is considered a required component of the Proposal.

vi. Offeror Prior Project Experience and Qualifications Form (Form 7f). The Offeror must utilize the Offeror Prior Project Experience and Qualifications Form to document the Offeror’s previous experience and expertise by completing a form for a minimum of three previous projects in the previous five years. These projects must be of similar size, scope, and nature to the Work in this RFP. Details of the similarities must be included.

The form(s) must be filled out completely for each of the projects required. The form(s) contained in this RFP have been customized for the applicable Offeror requirements. Each page of the form(s) may contain minor variations. If an Offeror elects to duplicate the form electronically, the Offeror must carefully review each page of the form to ensure that it has been copied accurately. Failure to duplicate the form exactly may lead to the rejection of the Proposal.

When contacted, each reference provided must be willing to discuss the Offeror’s previous performance on projects detailed on the form(s).

If this RFP allows qualifications and experience to be met through a subcontractor, the Offeror must identify the subcontractor by name in the appropriate part of the form(s) for each reference.

vii. Affirmation and Disclosure Form (Form 7g). The Offeror must complete, sign, and submit the Affirmation and Disclosure Form by uploading the signed document with its Proposal.

viii. Preference Certification Form (Form 7h). Offerors claiming preference for Domestic Source End Products, the Ohio (Buy Ohio) preference, and/or Veteran Friendly Business Enterprise (VBE) must complete the Preference Certification Form.

ix. Candidate Information Education and Training Form (Form 7i). The Offeror must complete a Candidate Information Education and Training Form for each candidate named in this RFP.

x. Candidate Experience Requirement Form (Form 7j). The Offeror must complete a Candidate Experience Requirement Form for each candidate named in this RFP.

xi. Offeror Redaction Justification Form (Form 7k). The Offeror must complete the Offeror Redaction Justification Form pursuant to the instructions in Section 3, subsection I, Proprietary Information, and Form 7k if the Offeror includes in its Proposal information it considers exempt from disclosure in a public records request.

xii. Proposed Pre-Existing Materials and Commercial Software Form (Form 7l). The Offeror must complete the Proposed Pre-Existing Materials and Commercial Software Form pursuant to the instructions below.

xiii. Offeror Proposed Exceptions and Assumptions (Form 7m). The Offeror must complete the Offeror Proposed Exceptions and Assumptions form pursuant to the instructions for Exceptions and Assumptions below and in the form.

xiv. Mandatory Requirements Form (Form 7n). The Offeror must complete all Mandatory Requirements Form(s). The Offeror must demonstrate that it meets all of the Mandatory Requirements listed in the Mandatory Requirements table in Section 6, Evaluation Metrics. The State will evaluate the Mandatory Requirements Form(s) to determine whether the Proposal meets all of the Mandatory Requirements.

Mandatory Requirements must be met by the Offeror itself. The Offeror’s subcontractors will not be accepted.

xv. Data Breach Disclosure Form (Form 7o). The Offeror must complete the Data Breach Disclosure Form. To complete this form, the Offeror must provide a complete list of every data breach incurred over the past five years. This list must include data breaches for every entity that could have access to State data under this agreement, including subcontractors. For each disclosure, the Offeror must include the applicable dates, the nature and scope of the breach, including the types of affected data (for example, PHI), and what mitigation actions were taken in response to the breach to ensure it does not happen again.

b. Scope of Work Response. The Offeror must provide a response to Part 1 – Scope of Work in this section of its Proposal. The content of Part 1 must not be modified. If the content of Part 1 is modified in any way, the Proposal may be disqualified. The Offeror must provide complete and coherent responses to Part 1 and demonstrate the ability to quickly undertake and successfully complete the Work under the Contract.

c. Acceptance of Terms and Conditions. The Offeror must include the entire content of Parts 2 through 4 as a single section in its Proposal. The Offeror must include a statement at the beginning of this section indicating that the Offeror has read, understands, and agrees to all of the terms and conditions contained in Parts 2 through 4.

d. Exceptions. If the Offeror has any exceptions or proposed changes to the technical requirements and/or the terms and conditions of this RFP, the Offeror must provide a comprehensive list of all such exceptions and proposed changes in Form 7m, Offeror Proposed Changes and Assumptions, of this RFP. In addition to listing the exceptions and proposed changes in Form 7m, the Offeror must also include its exceptions and proposed changes to the terms and conditions, if any, in a redlined format as an additional attachment to its Proposal. If any exception or proposed change is unacceptable to the State, the State may, in its sole discretion, request that the Offeror remove the exception or proposed change or may choose to reject the Proposal entirely. If the exceptions portion of Form 7m is left blank, the State will assume that the Offeror does not have any exceptions or proposed changes to the RFP. All agreed upon changes will become part of the Contract in Part 6, Mutually Agreed Upon Changes.

e. Assumptions. If the Offeror made any assumptions in preparing its Proposal, the Offeror must provide a comprehensive list of all such assumptions in Form 7m, Offeror Proposed Changes and Assumptions, of this RFP. If any assumption is unacceptable to the State, the State may, in its sole discretion, request that the Offeror remove the assumption or choose to reject the Proposal entirely. No assumptions may be included regarding the outcomes of negotiation, terms and conditions, or requirements. The assumptions listed in Form 7m of the Proposal, if any, must be inclusive of all assumptions with reference(s) to the section(s) of the RFP to which the assumption is applicable. Offerors should not include assumptions elsewhere in their Proposals. If the assumptions portion of Form 7m is left blank, the State will assume that the Offeror did not make any assumptions in preparing its Proposal.

f. Proof of Insurance. The Offeror must provide the certificate(s) of insurance required by Part 2 - Contract-Specific Terms and/or Conditions, if any, and Part 4 – Standard Terms and Conditions. The policy may be written on an occurrence or claims-made basis.

g. Legal Notice Address. The Offeror must provide the name, title, and address to which the State should send legal notices under the Contract.

h. Work Plan. The Offeror must submit a Work Plan that will be the basis of a later-created detailed comprehensive plan of action used to guide the Work, as applicable. In this plan, the Offeror must demonstrate a thorough understanding of the nature of the Work and what the Contractor must do to complete the Work properly. In addition, the Offeror must fully describe its current capacity, approach, methods, and specific processes and procedures for doing the Work. The elements of the Work Plan must include, at a minimum, all tasks and dependencies related to scope definition, requirements gathering, design, development, conversion, testing, benchmarking, implementation, training, and transition, as applicable.

The specifics of the Work Plan must include sufficient detail for the State to understand the Offeror’s knowledge and approach to the following: managing the Work; documenting planning decisions; facilitating communication among stakeholders; defining key management review as to content, scope, and schedule; and providing a baseline for progress measurement and Work control.

At a minimum, the Work Plan must include the following:

i. A description of the project management approach; and

ii. A high-level overview of the following subsidiary project management plans:

· Integration management,

· Scope management,

· Schedule management,

· Cost management,

· Quality management,

· Staffing management,

· Communications management, and

· Risk management (including constraints, planned responses, and contingencies).

If applicable to the Work, the Offeror must identify all proposed equipment needed for the Work during the installation, customization (as applicable), implementation, and ongoing operations phases. The Proposal must include the proposed manufacturer's name and model for all equipment. Additionally, the Offeror must identify any equipment that the State will require for the implementation and ongoing operation of the Work that is not otherwise specified in this RFP.

The State seeks insightful responses that describe proven state-of-the-art methods. Recommended solutions should demonstrate that the Offeror would be prepared to immediately undertake and successfully complete the Work. The Work Plan should clearly and specifically identify key Work personnel assignments. (NOTE: The Staffing Plan described below should be consistent with the Work Plan).

Additionally, in the Work Plan, the Offeror should address potential and known risks, and proposed risk mitigation strategies.

i. Staffing Plan and Time Commitment. The Offeror must provide a Staffing Plan identifying all proposed personnel by position that the Offeror proposes and that are required to do the Work. The Staffing Plan must show each individual’s responsibilities for the Work. The State also requires that the Staffing Plan match the proposed personnel and their qualifications to the activities and tasks set forth in the RFP for the Work. At a minimum, the Staffing Plan must identify the following proposed personnel: Implementation Manager, Account Executive, Claims Supervisor, Reporting and Outcomes Leader, and Account Manager.

In addition, the Staffing Plan must include the following information:

i. An organizational chart, including any subcontractors and key management and administrative personnel assigned to the Work.

ii. A contingency plan showing the ability to add more staff if needed to ensure meeting the Work due date(s).

iii. A statement and a chart that clearly indicate the time commitment of the proposed personnel for this Work during each of its phases.

iv. A statement indicating to what extent, if any, the proposed personnel may work on other projects or assignments that are not State related during the term of the Contract. The State may reject any Proposal that commits the proposed personnel to other projects during the term of the Work, if the State believes that any such commitment may be detrimental to the Offeror’s performance.

v. The Offeror must propose a Work team that collectively meets all of the requirements in this RFP. Each team member may have specific mandatory requirements listed in this RFP that the team member must individually meet.

vi. All proposed personnel must be named and meet the technical experience for the position.

In the case of any staffing requirements for a team of people, the Offeror must submit a team to do the Work that collectively meets all of the team requirements. The experience of multiple candidates may not be combined to meet a single requirement. Further, previous experience of the candidate submitted for an Account Manager position may not be used to meet any other team member requirements. Each candidate proposed for the Work team must meet at least one of the requirements.

j. Support Requirements from the State. The Offeror must describe the support it requests from the State in addition to any support the State has offered in this RFP. Specifically, the Offeror should address the following in this section of the Proposal:

i. The nature and extent of State support required in terms of staff roles, percentage of time available, etc.;

ii. The specific required assistance from State staff and the experience and/or qualification level required for such assistance; and

iii. Other support requirements.

The State may not be able or willing to provide the additional support the Offeror lists in this part of its Proposal. The Offeror must therefore indicate whether its request for additional support is a requirement for its performance. If any part of the list is a requirement, the State may reject the Proposal if the State is unwilling or unable to meet the requirements.

k. Pre-Existing Materials. If applicable, the Offeror must list any Pre-Existing Materials (defined in Part 4, section VI(D)) that will be included in a Deliverable in Form 7l in Part 7. The State may reject any Proposal that includes Pre-Existing Materials for a custom solution if the State believes that such is not appropriate or desirable for the Work.

l. Commercial Material. If applicable, the Offeror must list any Commercial Material (defined in Part 2, section C(2)), including Commercial Software (defined in Part 2, section C(3)), that the Offeror will deliver in which the State will have less than full ownership in Form 7l in Part 7. Generally, these will be from third parties. The Offeror need not list patented parts of equipment.

The Offeror must attach the applicable license agreement(s) for all Commercial Material for the State to review.

m. Information Security Assurances. The Offeror must provide assurance documentation of the Offeror’s effective design and implemented controls to meet the foundational trust principles of security, confidentiality, integrity, availability, and privacy. Documentation can include, but is not limited to, Federal Risk and Authorization Management Program (FedRAMP) authorization, GovRAMP authorization, Statement on Standards for Attestation Engagements (SSAE) No. 18, Service Organization Control 2 Type 2, International Organization for Standardization (ISO) 27001 , Health Information Trust Alliance (HITRUST) Certification or Assessment, Payment Card Industry Data Security Standard Attestation of Compliance (PCI-DSS AOC), Cloud Security Alliance (CSA) Security Trust Assurance and Risk (STAR) certification, Cybersecurity Maturity Model Certification (CMMC),certification, or other relevant IT security assurance documentation. This documentation will be considered confidential information of the Offeror. If the Offeror does not have any such documentation, it must provide a statement to that effect in its Proposal.

n. Response to Exhibit 1, State IT Policy, Standard and Service Requirements. The Offeror must include a fully completed copy of Exhibit 1 in its Proposal. The Offeror must follow the completion instructions contained in Exhibit 1 and must not modify the content of Exhibit 1.

o. Additional Innovation or Value-Added Services. The Offeror may propose additional innovation or value-added services that are outside of the scope of Work that it perceives to be valuable to the State but have not been defined in Part 1 – Scope of Work. In this section, the Offeror must describe in detail any value-added services included in its Proposal above the minimum requirements. The Offeror should describe what healthcare navigation services including its Member engagement strategies, tools, and educational materials. The Offeror should also include additional innovation or value-added services that are provided at no additional charge to the State.

p. Offeror Best Practices. The Offeror may propose alternative processing approaches, new tools, services, methodologies, business processes, or any other best practices that demonstrate a commitment to continuous improvement that are not included in Part 1 – Scope of Work for the State’s consideration. In this section, the Offeror must describe in detail any best practices included in its Proposal.

q. Completion of Exhibit 2, Business Associate Agreement. The Offeror must include a fully completed and signed copy of…