Actuarial Services C5903

The Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Medicaid Services, Division of Fiscal Management is seeking qualified actuarial services through RFP 2600000110 to support the state's Medicaid program. The procurement requires a qualified actuary or actuarial firm to develop actuarially certified rates for Managed Care Organizations (MCOs) and Non-Emergency Medical Transportation (NEMT) brokers in compliance with federal regulations under 42 CFR 438.6. Primary deliverables include MCO capitation rates, databooks, CMS Rate Setting Checklists, risk adjustment analyses using the Chronic Illness and Disability Payment System (CDPS) + Rx model, budget forecasting projections, medical loss ratio reconciliations, directed payment calculations, encounter data monitoring reports, and additional financial analysis services. The contractor must provide detailed cost proposals covering seven primary service categories with estimated hourly rates for various staffing levels including Project Manager (100 hours), Director-Actuary (175 hours), Consultants-Actuarial or IT (300 hours), Associates-IT or Support Staff (400 hours), and Administrative Support Staff (25 hours), with optional services available at established hourly rates. The initial contract term runs from July 1, 2026, through June 30, 2028, with potential renewal for up to two additional two-year periods. Proposal evaluation comprises three components: Technical Proposal (maximum 1,800 points), Cost Proposal (maximum 800 points), and optional Oral Presentations/Demonstrations (maximum 200 points), for a total of 2,800 possible points, with proposals scoring below 1,080 technical points eliminated from consideration. Written questions are due by April 13, 2026, at 2:00 PM EST, and proposals must be submitted by May 7, 2026, at 2:00 PM EST.

The procurement imposes specific insurance and compliance requirements on respondents, including Commercial General Liability Insurance with minimum limits of $1,000,000 per occurrence and $2,000,000 aggregate, and Professional Liability Insurance with minimum limits of $1,000,000 per claim. Contractors must submit a signed and notarized Required Affidavit for Bidders or Offerors and proof of good standing with the Kentucky Secretary of State, and must comply with all applicable federal requirements under 2 CFR Part 200, including Clean Air Act standards, debarment certifications, and lobbying activity disclosures. The RFP does not specify any set-aside designations for disadvantaged enterprises or restrictions limiting organizational types from responding. Performance-based penalties apply for late deliverables, ranging from $100 to $1,000 per business day depending on the deliverable type, with specific submission deadlines for risk adjustment deliverables including September 5, December 5, March 5, and June 5 of each fiscal year. The procurement does not identify incumbent vendors or current contractors, nor does it specify a guaranteed minimum contract use, as the Commonwealth reserves the right to award additional contracts for related work. No specific contract value or budget range is disclosed in the RFP documents.