T1683 Bid Amendment 4 09.15.2026 - Responses to Electronic Questions and Extended Quote Submission Due Date to 10.06.2026.docx

MIKIE SHERRILL

Governor State of New Jersey

DEPARTMENT OF THE TREASURY

DIVISION OF PURCHASE AND PROPERTY

PROCUREMENT BUREAU

33 WEST STATE STREET

P. O. BOX 230

TRENTON, NEW JERSEY 08625-0230

AARON BINDER

State Treasurer

DR. DALE G. CALDWELL

Lt. Governor

AMY F. DAVIS, ESQ.

Acting Director https://www.njstart.gov

September 15, 2026

To: All Interested Bidders

Re: Bid Solicitation # 26DPP01227 T1683 - Independent Health Care Appeals Program: Independent Utilization Review Organization, DOBI

Original Quote Submission Due Date: September 24, 2026 (2:00 p.m. Eastern Time) REVISED Quote Submission Due Date: October 6, 2026 (2:00 p.m. Eastern Time)

Bid Amendment #4

The following constitutes Bid Amendment #4 to the above referenced Bid Solicitation:

· This Bid Amendment includes:

· Extension of the Quote Submission Due Date from September 24, 2026, to October 6, 2026 (2:00 p.m. Eastern Time);

· Answers to questions;

· Revisions to the Bid Solicitation; and

· Revisions to the State-Supplied Price Sheet

· Please note that for all additions, deletions, clarifications and modifications to the Bid Solicitation, please refer to the Revised Bid Solicitation titled “T1683 Revised Bid Solicitation 09.15.2026” and hereafter referred to in this document as “Revised Bid Solicitation”. The following revision is included in the Revised Bid Solicitation:

· Cover Page – revised;

· Section 4.1, Method of Engagement – revised;

· Section 4.3.2, Review Agents – revised;

· Section 4.4.1, List of Prior Business Arrangements – revised;

· Section 4.4.2, Correspondence Forms – revised;

· Section 7.3, Additional Terms for a Contractor’s Data Protection Obligations – added;

· Section 9.3, Contract-Specific Definitions – revised.

· For all additions, deletions, clarifications and modifications to the T1683 State-Supplied Price Sheet 07.17.26, please refer to the Revised State-Supplied Price Sheet entitled “T1683 Revised State-Supplied Price Sheet 09.15.2026” hereafter referred to in this document as “Revised State-Supplied Price Sheet”. Bidders must submit the Revised State-Supplied Price Sheet as part of the Quote submission. The following revisions were made in the Revised State-Supplied Price Sheet:

· Price Lines 2 – The word Unit was removed from the description – revised; and

· Price Lines 3 – The word Unit was removed from the description – revised.

· Please note that T1683 Revised Bid Solicitation 09.15.2026 includes additions and/or revisions to the following Bid Solicitation Section from 9.0 State of New Jersey Standard Terms and Conditions Section:

· Section 9.1(4b), Additional Terms for a Contractor’s Data Protection Obligations – added – see Revised Bid Solicitation Section 7.3, Additional Terms for a Contractor’s Data Protection Obligations for revisions;

It is the sole responsibility of the Bidder to be knowledgeable of all of the additions, deletions, clarifications, and modifications to the Bid Solicitation and/or the New Jersey Standard Terms and Conditions relative to this Bid Solicitation as set forth in all Bid Amendments.

All other instructions, terms, and conditions of the Bid Solicitation shall remain the same.

Bid Solicitation #26DPP01227 T1683 - Independent Health Care Appeals Program: Independent Utilization Review Organization, DOBI

Answers to Questions

Where applicable, each question references the appropriate Bid Solicitation section.

Section Reference Question (Bolded) and Answer

Please be advised that all Quotes shall be submitted electronically through NJSTART.

Yes. Prior to the Quote Opening Deadline, a Bidder should review the documents comprising the submitted Quote to ensure that all of the required documents have been completed and attached. Oftentimes a Quote is deemed non-responsive because a Bidder fails to attach a required form or attaches a blank form. To review a submitted Quote, a Bidder should log into NJSTART and review each document attached to the Quote submission. Instructions on how to review a submitted Quote can be found in the Quick Reference Guide entitled How to Review a Submitted Quote, which is available on the NJSTART Vendor Support Page under Vendor Reference Guides.

It is recommended that users utilize Microsoft Edge to view PDFs. Certain PDF forms cannot be opened in the Chrome or Firefox built in PDF viewers that are enabled by default. If using Chrome or Firefox it is recommended that the file is downloaded instead by clicking the download button in the upper right-hand corner of the browser after an error message is received. An alternative option is to disable the built in PDF viewers in Chrome or Firefox.

As stated in Revised Bid Solicitation Section 2.2, Exceptions to the State of NJ Standard Terms and Conditions (SSTC): “Questions regarding the State of New Jersey Standard Terms and Conditions and exceptions to mandatory requirements MUST be posed during the Electronic Question and Answer period and shall contain the Bidder’s suggested changes and the reason(s) for the suggested change(s).” Moreover, as stated in Revised Bid Solicitation Section 3.11, Bidder Additional Terms Submitted with the Quote Bidder, proposed terms or conditions that conflict with those contained in the Bid Solicitation, the terms or conditions of this Revised Bid Solicitation, or State of New Jersey Standard Terms and Conditions will render a Quote non-responsive.

RFP Text: The purpose of this Bid Solicitation is to solicit Quotes for qualified Bidders to provide independent and objective managed care Utilization Reviews (UR) of Carrier internal appeal decisions as defined at N.J.A.C. 11:24-8.1 through 8.8, N.J.A.C. 11:24A-3.4 through 3.7, and N.J.A.C. 11:24A-5.1 on behalf of DOBI, whose statutes and regulations may be found at: http://www.state.nj.us/dobi/division_insurance/managedcare/mcstats.htm.

Question: Since this procurement is a reprocurement of the existing T1683 contract, have there been any significant changes in annual appeal volumes, clinical specialty distribution, expedited case volume, case complexity, regulatory requirements, or statutory requirements since award of the current contract that bidders should consider when developing staffing plans and pricing assumptions?

The annual appeal volume has increased over the life of the current contract. Clinical specialty distribution, expedited case volume, case complexity have increased relative to the increased volume. All program requirements are listed in the Contract.

Please provide the annual volumes for Preliminary Reviews, Full Reviews, and Expedited Reviews for each of the past three contract years.

Annual volumes for the past three (3) contract years are as follows:

Contract Year 2024: Preliminary Reviews 3,772; Full Reviews 2,198; Expedited Reviews 1,282.

Contract Year 2025: Preliminary Reviews 4,426; Full Reviews 2,627; Expedited Reviews 1,708.

Contract Year 2026: Preliminary Reviews 4,392; Full Reviews 1,749; Expedited Reviews 832.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

Please provide the approximate distribution of appeals by clinical specialty.

This information can be obtained from the Semi-Annual Legislative Report for Independent Health Care Appeals Program (IHCAP) listed on the New Jersey Department of Banking and Insurance (DOBI), website at the following link: NJDOBI | Independent Health Care Appeals Reports.

Please confirm that the 1,700 Full Reviews of Appeals and the 1,700 Expedited Reviews are not subsets of the 3,500 Preliminary Review of Appeals, i.e., the review estimate is 6,900 total (1,700 + 1,700 + 3,500).

The 1,700 Full Reviews of Appeals and the 1,700 Expedited Reviews are subsets of the 3,500 Preliminary Review of Appeals.

Unless specified otherwise, the data provided as part of this Bid Amendment is meant to be informational in nature, and the State makes no representations or guarantee as to such data during any contract term, including any extension(s) thereof.

Please confirm that the 1,700 Full Reviews of Appeals and the 1,700 Expedited Reviews are not subsets of the 3,500 Preliminary Review of Appeals, i.e., the review estimate is 6,900 total (1,700 + 1,700 + 3,500).

This is a duplicate question. Please refer to the answer to Question #8.

Is there a direct email for [Procurement Specialist]? If so, can the department please provide it?

The State declines to provide this information.

Per Revised Bid Solicitation Section 2.1, Electronic Question and Answer Period: “A Bidder shall not contact the Using Agency and/or the Procurement Specialist directly, in person, by telephone or by e-mail, concerning this Bid Solicitation, prior to Contract award.”

There is a break in the Q&A sequence after question 4. The next question (and answer) starts at 16. Where are questions 5-15?

All Bidder questions submitted are contained within this Bid Amendment.

How will answers to bidders' questions be posted?

Per Revised Bid Solicitation Section 2.1, Electronic Question and Answer Period, answers to Bidder questions will be issued by Bid Amendment on NJSTART within the Attachments tab.

Is there a file-size limit for uploads to NJSTART (e.g., 30 MB)? If so, please provide the maximum file size limit.

There is a 500 MB file size limit. Also, when uploading a file, the limit is based on the file size and internet speed. For example, if you are uploading a 499 MB file with a slow connection, the user may disconnect from the site before the upload is finished. The Bidder may submit its Quote in as many attachments as it deems necessary, provided that each attachment is accurately labeled so that it is clear to the State which Quote submission requirement(s) the submitted attachment(s) are responding to. Please refer to Revised Bid Solicitation Section 3, Quote Submission Requirements, for all Quote submission requirements.

Further, Bidders are strongly encouraged to visit the NJSTART Vendor Support Page, which contains Quick Reference Guides (QRGs), supporting videos, a glossary of NJSTART terms, and helpdesk contact information. Bidders should utilize the QRGs before attempting to submit a Quote through NJSTART. It is the Bidder’s responsibility to ensure that the Quote and attachments have been properly submitted. Inquiries concerning the use of NJSTART may be directed to njstart@treas.nj.gov.

This is a duplicate question. Please refer to the answer to Question #13.

A business can submit a proposal as the prime Contractor and perform the work without subcontractors.

This Revised Bid Solicitation is a Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract as stated in Revised Bid Solicitation Sections 1.1, Purpose, and Intent and Background, and Section 3.13.8.1, Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract.

Pursuant to Revised Bid Solicitation Section 3.13.8.1, Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract, if a Bidder intends to utilize a Subcontractor, it must make a good faith effort to utilize a Small Business (SBE) and/or Disabled Veterans’ Business (DVOB) Subcontractor where possible.

If the Bidder intends to subcontract, it must submit a Subcontractor Utilization Plan and shall take the actions outlined in Revised Bid Solicitation Section 3.13.8.1, Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract, A through E, to meet the set-aside subcontracting goal requirements before utilizing a non-Small Business and/or non-Disabled Veterans’ Business Subcontractor. If the Bidder finds no Small Business and/or Disabled Veterans’ Business Subcontractors that are interested, qualified, or capable of handling the work after conducting its good faith effort search, then it may select a non-Small Business and/or non-Disabled Veterans’ Business Subcontractor.

In accordance with Revised Bid Solicitation Section 9.2, Definitions, Subcontractor is defined as: “An entity having an arrangement with a Contractor, whereby the Contractor uses the products and/or services of that entity to fulfill some of its obligations under its State Contract, while retaining full responsibility for the performance of all Contractor's obligations under the Contract, including payment to the Subcontractor. The Subcontractor has no legal relationship with the State, only with the Contractor.

Please reference Revised Bid Solicitation Section 3.13.8, Subcontractor Utilization Plan, and Revised Bid Solicitation Section 3.13.8.1, Small Business and/or Disabled Veteran's Business Subcontracting Set-Aside Contract, for additional information.

If the Contractor is not using subcontractors to conduct any part of the scope of work, please confirm we do not need to submit a Subcontractor Utilization Plan with our proposal.

In accordance with Revised Bid Solicitation Section 3.13.8, Subcontractor Utilization Plan: “Bidders intending to use Subcontractor(s) shall list all Subcontractors on the Subcontractor Utilization Plan form or may list the Subcontractor(s) on the “Subcontractor” Tab in NJSTART.

For a Quote that does NOT include the use of any Subcontractors, the Bidder is automatically certifying that, if selected for an award, the Bidder will be performing all work required by the Contract.”

Please refer to the answer to Question #15 for additional information.

If the Contractor is not using subcontractors to conduct any part of the scope of work, please confirm we do not need to submit a Subcontractor Utilization Plan with our proposal.

This is a duplicate question. Please refer to the answer to Question #16.

If the Contractor is not using subcontractors to conduct any part of the scope of work, please confirm we do not need to document and submit with our proposal good faith effort to achieve the subcontractor set-aside goals.

If a Bidder is not using a subcontractor, the Bidder does not need to submit a good faith effort search with their proposal.

Pursuant to Revised Bid Solicitation Section 3.13.8.1, Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract, if a Bidder intends to utilize a Subcontractor, it must make a good faith effort to utilize a Small Business (SBE) and/or Disabled Veterans’ Business (DVOB) Subcontractor where possible.

If the Contractor is not using subcontractors to conduct any part of the scope of work, please confirm we do not need to document and submit with our proposal good faith effort to achieve the subcontractor set-aside goals.

This is a duplicate question. Please refer to the answer to Question #18.

Would the State please clarify that there are no small business set aside requirements for the prime contract?

Please refer to the answer to Question #15

RFP Text: Small Business Set-Aside For Goods and Services: I, II, III Subcontracting Only Disabled Veteran-Owned Business Set-Aside Subcontracting Only Question 1: The solicitation identifies Small Business Enterprise (SME) Set-Aside, Categories I, II, and III and a Disabled Veteran-Owned Business (DVOB) Set-Aside category indicate "Subcontracting Only." It is unclear whether this procurement is restricted to certified small businesses as prime contractors or whether the SBE requirements apply solely to subcontracting participation.

Questions A - Can a large business submit a proposal as the prime contractor, or is eligibility to serve as the prime contractor limited to certified small businesses? If large businesses are eligible to bid as prime contractors, may they perform the work without subcontractors?

Please refer to the answer to Question #15.

Question B - If so, is the bidder penalized during the proposal evaluation process for not utilizing SBEs or DVOBs as subcontractors?

No, the Bidder will not be penalized during the proposal evaluation process for not utilizing Small Business Enterprise or Disabled Veteran-Owned Business as subcontractors.

In accordance with Revised Bid Solicitation Section 3.13.8, Subcontractor Utilization Plan: “For a Quote that does NOT include the use of any Subcontractors, the Bidder is automatically certifying that, if selected for an award, the Bidder will be performing all work required by the Contract.”

However, if a Bidder intends to utilize a Subcontractor, it must make a good faith effort to utilize a Small Business (SBE) and/or Disabled Veterans’ Business (DVOB) Subcontractor where possible, pursuant to Revised Bid Solicitation Section 3.13.8.1, Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract.

Please refer to the answer to Question #15 for additional information.

Question C - Question 2: The solicitation also identifies Small Business Enterprise (SBE) and Disabled Veteran-Owned Business (DVOB) participation as "Subcontracting Only." Is there a mandatory subcontracting participation requirement for certified SBE and/or DVOB firms? If so, please specify the required percentage of contract value, scope of work, or other participation goals that must be subcontracted to certified firms.

It is not mandatory that the Bidder utilize only Small Business and/or Disabled Veterans’ Business Subcontractors. There is no specific set-aside percentage goal for this specific contract.

However, if a Bidder intends to utilize a Subcontractor, it must make a good faith effort to utilize a Small Business (SBE) and/or Disabled Veterans’ Business (DVOB) Subcontractor where possible, pursuant to Revised Bid Solicitation Section 3.13.8.1, Small Business and/or Disabled Veterans’ Business Subcontracting Set-Aside Contract.

RFP Text: The Quote should be submitted with the attachments organized in the following manner: * Forms * Technical Quote * State-Supplied Price Sheet * State of New Jersey Security Due Diligence Third Party Information Security Questionnaire Question: Please confirm that the Technical Quote only includes responses to: * Section 3.14, which includes responses to all of Section 4 - Scope of Work * Section 3.15 through Section 3.24 That is, does the Technical Quote include responses for any other section outlined in the Bid Solicitation? If so, please outline the exact contents of the Technical Quote.

Per Revised Bid Solicitation Section 3.14, Technical Quote: “The Bidder shall describe its approach and plans for accomplishing the work outlined in the Scope of Work. The Bidder must set forth its understanding of the requirements of this Revised Bid Solicitation and its approach to successfully complete the Contract. The Bidder should include the level of detail it determines necessary to assist the Evaluation Committee in its review of the Bidder’s Quote.”

This section is titled "Organization Charts" (plural); however, it references "an organization chart" and goes on to describe the requirements for only one organization chart. Please confirm Contractors are to provide only one organization chart with our proposal.

The Bidder should include the level of detail it determines necessary to assist the Evaluation Committee in its review of the Bidder’s Quote.

In accordance with Revised Bid Solicitation Section 3.20, Organization Charts: “The Bidder should include an organization chart, with names showing management, supervisory and other key personnel (including Subcontractor management, supervisory, or other key personnel) to be assigned to the Contract. The chart should include the labor category and title of each such individual.”

This section is titled "Organization Charts" (plural); however, it references "an organization chart" and goes on to describe the requirements for only one organization chart. Please confirm Contractors are to provide only one organization chart with our proposal.

Please refer to the answer to Question #23.

Bid Solicitation Section 4.3.2 - Review Agents; and Bid Solicitation Section 9.3 - Contract-Specific Definitions RFP Text: The Contractor shall submit a list of its Review Agents to the SCM.

Question A - Question 1: Does the State want this list submitted with our proposal or upon contract award?

In accordance with Revised Bid Solicitation Section 4.3.2, Review Agents: ”The Contractor shall submit a list of its Review Agents to the SCM 30 Calendar Days before the Contract effective date.”

Please refer to Revised Bid Solicitation, Section 4.3.2, Review Agents, as this Section has been revised.

Question B - Question: 2: Can the State please clarify who it considers Review Agents? Is it only the individuals performing preliminary reviews?

In accordance with Revised Bid Solicitation 9.3, Contract-Specific Definitions, Review Agents are defined as: "Registered Nurses and Physicians who are employed by or contracted with the Contractor/IURO. The Registered Nurse reviewer makes sure the application is complete and all medical records are included. The Physician makes the decision.”

Please refer to Revised Bid Solicitation, Section 9.3, Contract-Specific Definitions, as this Section has been revised.

Question C - Is it only the individuals performing preliminary reviews?

In accordance Revised Bid Solicitation Section 4.3.2, Review Agents: “The Contractor shall ensure that a Preliminary Review be conducted by a Registered Nurse or a licensed Physician, as a Review Agent.”

In accordance with Revised Bid Solicitation Section 9.2, Definitions: “Should – Denotes that which is permissible or recommended, not mandatory.”

In accordance with Revised Bid Solicitation Section 3.22, Experience with Contracts of Similar Size and Scope: “A description of all such contracts should be included and should show how such contracts relate to the ability of the firm to complete the services required by this Bid Solicitation. For each such contract listed, the Bidder should provide two (2) names and telephone numbers of individuals for contracting party.”

The Bidder should include the level of detail it determines necessary to assist the Evaluation Committee in its review of the Bidder’s Quote.

RFP Text: Price Line 1 - Submit all-inclusive Firm Fixed Price for EACH Preliminary Review per Bid Solicitation Section 4.2.1, Preliminary Review of Appeals; Price Line 2 - Submit all-inclusive Firm Fixed Price for EACH Full Review per Bid Solicitation Section 4.2.2, Full Review of Appeals; and Price Line 3 - Submit all-inclusive Firm Fixed Price for EACH Expedited Review per Bid Solicitation Section 4.2.8.2, Expedited Reviews. Question: Can the State provide the current contract firm fixed pricing for Preliminary Reviews, Full Reviews, and Expedited Reviews?

Pursuant to Revised Bid Solicitation Section 1.2, Background, this is a reprocurement of the services under T1683 - Independent Health Care Appeals Program: Independent Utilization Review Organization. Bidders interested in reviewing the expiring Contract’s specifications and pricing information may do so by following the instructions Revised Bid Solicitation Section 1.2, Background.

RFP Text: If the Contractor determines that a conflict of interest would be present, should they accept the External Appeal, the Contractor shall forward the request for an External Appeal to SCM. Question: If the selected contractor identifies a conflict of interest, what process will the State use to ensure timely handling of the appeal, and will another IURO be engaged by the State?

Upon determination of a conflict of interest with the Contractor and its Review Agents, and the Contractor having forwarded the request to DOBI, DOBI will provide the Contractor with notification of the request as applicable for the External Appeal; within this notification, instructional next steps will be provided.

There will be no other Independent Utilization Review Organization (IURO) engaged by the State.

Please refer to Revised Bid Solicitation, Section 4.1, Method of Engagement, as this Section has been revised.

RFP Text: If the Contractor determines that the Covered Person was deprived of a Medical Necessity of Covered Service, the Contractor shall determine the appropriate covered health care service the Covered Person should receive within the coverage limits of the Covered Person's with the Carrier. Question: Can the State provide a case example of this type of review?

An example would be:

A Provider prescribes medication A to treat a condition for 3 months. Health carrier denies the medication as not medically necessary and disputes amount of time needed. IURO reviews are medical records submitted from provider and health carrier and determines if medication A is medically necessary, IURO then determines if it required for the length of time requested or a lesser amount of time based upon submitted medical documentation.

In accordance with Revised Bid Solicitation Section 4.2, Responsibilities of the Contractor: “The Contractor shall complete a Preliminary Review of an External Appeal and, if it is accepted for processing by the Contractor, perform a Full Review, issue a decision, and communicate its findings in writing to the Covered Person and/or Provider, the Carrier, and the SCM.”

Please confirm that the Contractor is expected to conduct a preliminary review for every case received.

This is a duplicate question. Please refer to the answer to Question #30.

RFP Text: The Provider acting on behalf of a Covered Person, with the Covered Person's consent, has provided all information required by the Contractor and DOBI to make the preliminary determination, including the appeal form and a copy of any information provided by the Carrier regarding its decision to deny, reduce, or terminate the Covered Service, and a fully executed release to obtain any necessary medical records from the Carrier and any other relevant health care Provider. Question: Can the State provide the historical data regarding average records volume per case or average pages submitted for Preliminary, Full, and Expedited Reviews?

It is not possible to provide the averages requested. Each case is unique. Average amount of documentation submitted varies by provider, health carrier, condition, treatment and research documentation.

RFP Text: The Contractor shall ensure: E. That all Full Reviews be referred to and completed by a licensed, Board Certified Consultant Physician Reviewer who is in the same specialty or area of practice and who would generally manage the type of treatment that is the subject of the External Appeal Question: Can the State provide a breakdown of cases by major clinical specialty (e.g., oncology, behavioral health, surgery, rehabilitation, cardiology, etc.) for the most recent contract period?

This information can be obtained from the Semi-Annual Legislative Report for the Independent Health Care Appeals Program (IHCAP) listed on the New Jersey Department of Banking and Insurance (DOBI), website at the following link: NJDOBI | Independent Health Care Appeals Reports.

RFP Text: The Contractor shall ensure that the Medical Director appointed by the Contractor is licensed to practice medicine in the State and shall serve as the overall Medical Director of the Contractor. Question: Must the Medical Director be licensed specifically in New Jersey, or is a physician licensed in another state and eligible for reciprocity acceptable?

The Medical Director must be licensed in New Jersey (NJ); reciprocity is not acceptable.

RFP Text: The Contractor shall maintain a current list that identifies all Carriers, health care facilities, and other health care Providers with which the Contractor maintains a health care services-related business arrangement and submit the list to the SCM. This list shall include a brief description of the nature of any such arrangement and shall be updated by the Contractor when changes occur. The Contractor shall ensure a list of the names and affiliations of the board members of each Contractor are also submitted to the SCM and shall be updated when changes occur. Question: Does the State want these lists submitted with our proposal or upon contract award?

In accordance with Revised Bid Solicitation Section 4.4.1, List of Prior Business Arrangements the Contractor shall… “submit the list to the SCM within five (5) Business Days after notification of Contract Award.”

Please refer to Revised Bid Solicitation Section 4.4.1, List of Prior Business Arrangements, as this Section has been revised.

RFP Text: The Contractor shall provide the SCM copies of all forms used in correspondence regarding the IHCAP process. This includes Letters of Notice for whether the External Appeal was accepted for processing and for the External Appeal decision. The Contractor shall ensure these forms are submitted to the SCM and approved by the SCM prior to their use. Question: Does the State want these forms submitted with our proposal or upon contract award?

In accordance with Revised Bid Solicitation Section 4.4.2, Correspondence Forms: “The Contractor shall ensure these forms are submitted to the SCM within five (5) Business Days after notification of Contract Award.”

Please refer to Revised Bid Solicitation Section 4.4.2, Correspondence Forms, as this Section has been revised.

Question A - RFP Text: The number of External Appeals conducted, listed by clinical category and by Pre-Service Appeal and Post-Service Appeal classification and their outcomes; Question 1: What clinical categories does DOBI currently use when reporting external appeal outcomes?

This information can be obtained from the Semi-Annual Legislative Report for the Independent Health Care Appeals Program (IHCAP) listed on the New Jersey Department of Banking and Insurance (DOBI), website at the following link: NJDOBI | Independent Health Care Appeals Reports.

Question B - Question 2: What format does DOBI request this report be in?

Reports are to be submitted in Microsoft Word and Excel.

RFP Text: The Contractor shall submit an annual report to the SCM within 30 Calendar Days of the end of each calendar year in a format determined by the SCM. Question: Can the State provide the previous calendar year's annual report?

This information can be obtained from the Semi-Annual Legislative Report for the Independent Health Care Appeals Program (IHCAP) listed on the New Jersey Department of Banking and Insurance (DOBI), website at the following link: NJDOBI | Independent Health Care Appeals Reports.

RFP Text: The Contractor shall submit an invoice to the respective Carrier at the time the Contractor's written decision is rendered and sent to the Carrier. Question: Since the Contractor invoices and collects payment directly from carriers, can the State provide historical carrier payment compliance rates and average payment turnaround times?

The State declines to provide this information. This data is not available.

Please confirm the anticipated contract start date is 1/1/2027.

The anticipated Contract start date has not been determined.

In accordance with Revised Bid Solicitation Section 5.1, Contract Term and Extension Option: “The anticipated Contract effective date is provided on the “Summary” page of the Bid Solicitation in NJSTART. If delays in the procurement process result in a change to the anticipated Contract effective date, the Contractor agrees to accept a Contract for the full term of this Contract.”

Please confirm the anticipated contract start date is 1/1/2027.

This is a duplicate question. Please refer to the answer to Question #40.

There is no Performance Bond required for this Contract.

In accordance with Revised Bid Solicitation Section 5.3, Performance Security: “Not applicable to this procurement.”

Would the state please define what constitutes a "usable format" for the return of State Data under Bid Solicitation Section 6.7(I), Privacy. If specific file types, data structures, or export standards are required, please identify those requirements.

Per Revised Bid Solicitation Section 6.7 (I), Privacy, data would be provided in an open standards machine-readable format.

Would the State consider revising the 3rd line of this to read as "Contractor's Confidential Information, to the extent not expressly prohibited by law, shall consist of all information clearly identified as confidential at the time of disclosure and Contractor Intellectual Property ("Contractor Confidential Information)"? The "and" has been added for clarity.

The State does not accept the proposed modification. Terms and conditions on publicly bid procurements must be consistent for all potential Bidders.

Bid Solicitation Section 6.7 - Privacy

The Solicitation and Attachment 1 have conflicting requirements for reporting a Breach of Security. Will the State please clarify which notification timeframe governs a Breach of Security, Solicitation 6.7(G) (immediately, but no later than 72 hours after learning of the breach) or Attachment 1 9.1(4)(b) (immediately and within 24 hours)?

The State is extending the requirement to 72 hours for consistency with State of New Jersey Combined Terms and Conditions Section 3.12, Cybersecurity Incident Reporting.

Please refer to Revised Bid Solicitation Section 7.3, Additional Terms for a Contractor’s Data Protection Obligations, for additional information, as this section has been revised.

Page 2 of the Confidentiality and Commitment to Defend form includes a table with limited space for providing the required "statutory or other legal reason for each requested exemption." Please confirm that the Contractor may recreate the table from Page 2 to allow sufficient room for our responses and submit the revised table together with Page 1 of the form.

The Bidder may attach additional sheets, if necessary, to the Confidentiality and Commitment to Defend form.

Page 2 of the Confidentiality and Commitment to Defend form includes a table with limited space for providing the required "statutory or other legal reason for each requested exemption." Please confirm that the Contractor may recreate the table from Page 2 to allow sufficient room for our responses and submit the revised table together with Page 1 of the form.

This is a duplicate question. Please refer to the answer to Question #46.

If the Bidder has no plans for Subcontracting, where on the SUBCONTRACTOR UTILIZATION FORM do we indicate "N/A"?

The Bidder may input "N/A" or “Not Applicable” in the Subcontracor Utilization Plan form if subcontracting services are not to be utilized.

Are entities required to be FedRamp or StateRamp cert or can SOC 2TYPE II suffice? RAMP auth were listed in documents to be submitted...

FedRAMP and GovRAMP (formerly StateRAMP) are not requirements but are accepted by the State. However, the State requests the submission of the SOC2 Type 2 audit report as a supplement to the responses within Attachment 3 - State of New Jersey Security Due Diligence Third-Party Information Security Questionnaire.

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