CalHEERS Pre-Solicitation RFP #73040873

The State of California, specifically the Office of Technology and Solutions Integration (OTSI), is releasing a Pre-Solicitation Request for Proposal (RFP #73040873) for System Development, Maintenance & Operations (SDMO) for the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS). The procurement seeks a comprehensive technology solution to support and enhance the CalHEERS Project, which facilitates health insurance enrollment and eligibility processes for Covered California and the Department of Health Care Services (DHCS). The system must support critical functions including account creation, consumer application processing, complex eligibility rule application, and health plan selection for insurance affordability programs. Key system requirements include interfacing with the Statewide Automated Welfare Systems (SAWS) for Modified Adjusted Gross Income (MAGI) Medi-Cal eligibility, enrollment, and reporting, as well as providing data for potential eligibility to other social service programs like non-MAGI Medi-Cal, CalFresh, and CalWORKS. The pre-solicitation was posted on March 7, 2025, with a final proposal due date of October 6, 2025, providing potential vendors approximately seven months to prepare their submissions.

While specific set-aside designations are not explicitly detailed in the provided information, vendors should carefully review the attached documents, particularly the "Pre-Solicitation_RFP_Rev_5.0_All-In-One.pdf" and "Pre-Solicitation_Instructions.docx" for complete qualification requirements. The procurement appears to target sophisticated technology service providers with extensive experience in complex healthcare eligibility and enrollment systems integration. The system's current infrastructure supports multiple state agencies and interfaces with various welfare and social service platforms, suggesting a need for vendors with robust technical capabilities and demonstrated experience in large-scale, multi-system government technology projects. Potential respondents should be prepared to demonstrate expertise in healthcare technology, government system integration, eligibility rule management, and data exchange capabilities. While specific budget ranges are not provided in the summary document, the comprehensive nature of the project and its statewide impact suggest a significant potential contract value. Interested vendors are encouraged to utilize the "Template_for_Feedback_Pre-Solicitation.xlsx" to provide input and clarify any questions during the pre-solicitation phase.