EDE-first State Based Exchange

The Office of Management and Enterprise Services (OMES) Central Purchasing division is requesting proposals on behalf of the Oklahoma Insurance Department for a comprehensive Exchange-enabling solution and associated services to support Oklahoma's operation of an EDE-first State-Based Exchange, with proposals due August 26, 2026 under RFP solicitation EV00000956. This procurement is mandatory for bidders to demonstrate proven experience delivering full-lifecycle implementations of large-scale public sector or health insurance marketplace systems across at least two states, including design, configuration, testing, deployment, transition to operations, and ongoing maintenance and operations, with each reference supporting at least 100,000 enrollees—a hard capability floor that filters the competitive field significantly.

The scope encompasses design, development, and implementation of a technology platform supporting eligibility governance, enrollment orchestration, case management, issuer coordination, and regulatory reporting within a distributed partner ecosystem leveraging Oklahoma Enrollment Partners (OKEPs) as the primary enrollment channel alongside a compliant state consumer portal. The solution must operate within a State-owned and State-governed cloud environment aligned with Oklahoma OMES enterprise architecture standards, with full State ownership of all data, configurations, and developed intellectual property. The implementation lifecycle spans Design, Development, and Implementation (DDI), Technology Transition (TT), and Maintenance and Operations (M&O) phases, with transition from the Federally Facilitated Marketplace to a State-Based Exchange required. The supplier must establish a Service Center functioning as Tier 2 support, manage outbound consumer communications and notices, support document processing and appeals, and provide comprehensive EDE partner integration and services.

The initial contract term runs through July 2027 with up to four optional one-year renewals. Based on Plan Year 2026 enrollment metrics, Oklahoma processed 219,383 submitted applications resulting in 261,887 plan selections. The cost proposal must account for implementation, technology transition, and ongoing maintenance and operations beginning in August 2026 for a planned 2028 plan-year launch with 250,000 members annually, with a 90-calendar-day warranty period of defect correction and remediation at no additional cost.

Bidders must complete a Requirements Traceability Matrix (RTM) demonstrating how proposed solutions address functional, technical, implementation, and operational requirements across five primary categories: Program Foundations, Technical, Functional, Service Center, and Implementation. The solution must comply with 45 CFR Part 155, CMS standards, HIPAA, IRS Publication 1075, OMES security requirements, WCAG 2.2 and ADA accessibility standards, and achieve 99.9% API availability during open enrollment periods with response times under 2.0 seconds median for critical transactions. Service level agreements impose liquidated damages of $10,000 per hour during open enrollment and $5,000 per hour during special enrollment periods for API availability shortfalls, capped at $250,000 monthly, with escalated damages up to 2x multiplier during the final two weeks of open enrollment for sustained breaches. Planned maintenance is limited to 4-hour windows occurring no more than twice monthly, with seven calendar days' advance notice required.

Evaluation follows a multi-stage process: administrative review for compliance and mandatory qualifications; technical and business proposal evaluation using standardized scoring; oral presentations (structured across seven demonstration scenarios totaling 140 minutes), reference checks, and best and final offers; and apparent successful bidder selection. Scoring categories include bidder experience and qualifications, delivery approach and program management, technical solution and architecture, service delivery ecosystem and operational support, program integrity and compliance, staffing model and key personnel, and cost realism. Award will be given to the bidder providing best value rather than necessarily the lowest cost. The State reserves the right to establish a competitive range, request clarifications and discussions, conduct site visits, and apply tie-breaking criteria based on technical scores or critical category performance.

Bidders must submit minimum three completed reference questionnaires with documented marketplace experience, with at least two references demonstrating experience aligned with Section 3.1 minimum requirements and at least two separately demonstrating experience aligned with Section 3.3 minimum requirements. All proposals must include financial information (up to three years of audited financial statements and tax returns), business references, certifications, and an Authority to Operate (ATO) for IT components. All submissions must use the Oklahoma Supplier Portal exclusively. Questions are due August 7, 2026, and administrative review requests are due July 30, 2026. Contracting Officer Samantha Fox (Samantha.fox@omes.ok.gov, 405-522-6266) is the sole authorized contact for bidder inquiries. Bid prices must be firm and fixed for the contract term with optional renewals, and all bids must remain valid for 120 days post-deadline.